Interstitial high-dose-rate brachytherapy as salvage treatment for locally recurrent prostate cancer after definitive radiation therapy: Toxicity and 5-year outcome.
We report our results with interstitial high-dose-rate brachytherapy (HDR-BT) as a salvage therapy option after external beam therapy with or without BT. Emphasis was put on toxicity and 5-year outcome.



From 2003 to 2011, 29 patients with local failure after previous radiotherapy for prostate cancer were treated with salvage interstitial HDR-BT. The diagnosis of local recurrence was made on the basis of choline positron emission tomography. Salvage HDR-BT was given in three fractions with a single dose of 10 Gy per fraction and weekly. The target volume covered the peripheral zone of the prostate and the positron emission tomography-positive area. Acute and late toxicities were documented according to common terminology criteria for adverse events (CTCAE v 4.0).



Twenty-two patients with minimum followup of 60 months were analyzed. The 5-year overall survival was 95.5% with a disease-specific survival of 100%. The 5-year biochemical control was 45%. Late grade 2 gastrointestinal toxicities were observed in two patients (9%). No grade 3 or higher gastrointestinal late toxicities were observed. Urinary incontinence found in 2 patients (9%) and grade 2 obstruction of urinary tract occurred in one patient (4%).



Interstitial HDR-BT was feasible and effective in the treatment of locally recurrent prostate cancer after definitive radiotherapy. The long-term toxicity was low and acceptable.
Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel, Germany. Electronic address: ping.jiang@uksh.de.
Ping
P
Jiang
Department of Urology, Community Clinic Kiel, Kiel, Germany.
Christof
C
van der Horst
Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Bernhard
B
Kimmig
Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Fabian
F
Zinsser
University Clinic for Medical Radiation Physics, Medical Campus Pius-Hospital, Carl von Ossietzky University, Oldenburg, Germany.
Bjoern
B
Poppe
Department of Nuclear Medicine, University Clinic Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Ulf
U
Luetzen
Department of Urology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Klaus-Peter
KP
Juenemann
Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel, Germany; Department of Radiation Oncology, University of Copenhagen, Copenhagen, Denmark.
Juergen
J
Dunst
Department of Radiation Oncology, University Clinic Schleswig-Holstein, Campus Kiel, Kiel, Germany.
Frank-André
FA
Siebert
D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D019160:Endosonography; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D049268:Positron-Emission Tomography; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000453:epidemiology / Q000209:etiology; D011878:Radiotherapy; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods; D017211:Treatment Failure; D016896:Treatment Outcome; D014463:Ultrasonography; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology
Interstitial HDR brachytherapy; Prostate cancer; Recurrence