title: Salvage brachytherapy for local recurrences of prostate cancer treated previously with radiotherapy.
abstract: OBJECTIVE
  The aim of the study was to analyze early effects and toxicity of salvage high dose rate brachytherapy for local recurrences of adenocarcinoma of the prostate after external beam radiotherapy (EBRT).
  
  
  METHODS
  In MCS Memorial Institute of Oncology in Gliwice a research programme on salvage HDR brachytherapy for local recurrences of prostate cancer treated previously with EBRT has been ongoing since February 2008. The treatment consisted of 3 fractions of 10 Gy each given every 14 days. Maximal urethral doses were constrained to be ≤ 120% of the prescribed dose. Maximal bladder and rectum doses were constrained to be ≤ 70% of the prescribed dose.
  
  
  RESULTS
  Fifteen eligible patients were treated and analyzed from February 2008. All patients completed the treatment without major complications. The most common early complications were: macroscopic haematuria, pain in lower part of the abdomen, and transient dysuria. During the first week after the procedure a transient increase in IPSS score was noticed. The Foley catheter was removed on day 2 to 5. No complications after spinal anaesthesia were observed. Acute toxicity according to EORTC/RTOG was low. For bladder EORTC/RTOG score ranged from 0 to 2. Only in two patients grade 1 toxicity for rectum was observed. The follow-up ranged from 3 to 9 months. In one patient grade 2 rectal toxicity was observed, and one had urethral stricture. Other patients did not have any other significant late toxicity of the treatment. Two patients developed bone metastases.
  
  
  CONCLUSIONS
  Salvage brachytherapy for localized prostate cancer (3 × 10 Gy every 14 days) seems to be a safe and well tolerated procedure. A significant decline in prostate-specific antigen (PSA) level is seen in patients with hormone-responsive cancer. Long-term efficiency and toxicity of the procedure are yet to be established.
authors.affiliation: 2 Department of Radiotherapy.
authors.forename: Marzena
authors.initials: M
authors.lastname: Gawkowska-Suwinska
authors.affiliation: Department of Brachytherapy.
authors.forename: Marek
authors.initials: M
authors.lastname: Fijałkowski
authors.affiliation: Department of Brachytherapy.
authors.forename: Brygida
authors.initials: B
authors.lastname: Białas
authors.affiliation: Department of Physics.
authors.forename: Marta
authors.initials: M
authors.lastname: Szlag
authors.affiliation: Department of Brachytherapy.
authors.forename: Sylwia
authors.initials: S
authors.lastname: Kellas-Ślęczka
authors.affiliation: 2 Department of Radiotherapy.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Nowicka
authors.affiliation: 2 Department of Radiotherapy.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Behrendt
authors.affiliation: 2 Department of Radiotherapy.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Plewicki
authors.affiliation: 2 Department of Radiotherapy.
authors.forename: Beata
authors.initials: B
authors.lastname: Smolska-Ciszewska
authors.affiliation: 2 Department of Radiotherapy.
authors.forename: Monika
authors.initials: M
authors.lastname: Giglok
authors.affiliation: 2 Department of Radiotherapy.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Zajusz
authors.affiliation: Department of Radiotherapy, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Owczarek
keywords: prostate cancer; radiotherapy; recurrences; salvage brachytherapy