Salvage Brachytherapy for Biochemically Recurrent Prostate Cancer following Primary Brachytherapy.
Purpose. In this study, we evaluated our experience with salvage brachytherapy after discovery of biochemical recurrence after a prior brachytherapy procedure. Methods and Materials. From 2001 through 2012 twenty-one patients treated by brachytherapy within University of Kentucky or from outside centers developed biochemical failure and had no evidence of metastases. Computed tomography (CT) scans were evaluated; patients who had an underseeded portion of their prostate were considered for reimplantation. Results. The majority of the patients in this study (61.9%) were low risk and median presalvage PSA was 3.49 (range 17.41-1.68). Mean follow-up was 61 months. At last follow-up after reseeding, 11/21 (52.4%) were free of biochemical recurrence. There was a trend towards decreased freedom from biochemical recurrence in low risk patients (p = 0.12). International Prostate Symptom Scores (IPSS) increased at 3-month follow-up visits but decreased and were equivalent to baseline scores at 18 months. Conclusions. Salvage brachytherapy after primary brachytherapy is possible; however, in our experience the side-effect profile after the second brachytherapy procedure was higher than after the first brachytherapy procedure. In this cohort of patients we demonstrate that approximately 50% oncologic control, low risk patients appear to have better outcomes than others.
Department of Urology, University of Kentucky College of Medicine, Lexington, KY 40536, USA.
John M
JM
Lacy
Department of Radiation Oncology, University of Kentucky College of Medicine, Lexington, KY 40536, USA.
William A
WA
Wilson
University of Kentucky College of Medicine, Lexington, KY 40536, USA.
Raevti
R
Bole
Department of Biostatistics, University of Kentucky College of Public Health, Lexington, KY 40536, USA.
Li
L
Chen
Comprehensive Cancer Centers of Nevada, Las Vegas, NV 89169, USA.
Ali S
AS
Meigooni
Department of Urology, University of Kentucky College of Medicine, Lexington, KY 40536, USA.
Randall G
RG
Rowland
Department of Radiation Oncology, University of Kentucky College of Medicine, Lexington, KY 40536, USA.
William H St
WH
Clair