Salvage brachytherapy for recurrent prostate cancer
| Autor: | Carlos Vargas, Jason Koziol, Apoorva R. Vashi, Kathleen Kiley, Ali Kasraeian, Jamie A. Cesaretti, Douglas A. Swartz, Mitchell Terk, Marc Blasser |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Brachytherapy Urology Salvage therapy Androgen suppression Prostate cancer medicine Humans Radiology Nuclear Medicine and imaging Aged Aged 80 and over Salvage Therapy business.industry Prostatic Neoplasms Middle Aged medicine.disease Radiation therapy Treatment Outcome Oncology Recurrent prostate cancer Neoplasm Recurrence Local business Salvage brachytherapy Prostate brachytherapy |
| Zdroj: | Brachytherapy. 13(1) |
| ISSN: | 1873-1449 |
| Popis: | To evaluate the role of salvage prostate brachytherapy for locally recurrent prostate cancer after external beam radiation alone.Sixty-nine consecutive patients treated with salvage brachytherapy after a local failure were analyzed. All patients were found to have pathologic proven recurrent prostate cancer at least 2 years after initial therapy and no regional or distant disease on imaging studies. Pd-103 was used with a prescribed pD90 of 100 Gy. In total, 89.9% of patients received androgen suppression (AS) as part of their salvage therapy. Patients whose prostate-specific antigen5.0 ng/mL while on AS were considered to have castration resistant prostate cancer (CRPC). Patients on AS6 months before salvage brachytherapy were considered to have delayed therapy. Patients retreated within 5 years after their initial treatment were considered to have early failures.Total median followup after salvage therapy was 5.0 years (0.6-13.7). From the date of salvage, 5-year biochemical control for low-risk patients was 85.6%, intermediate-risk patients 74.8%, and high-risk patients 66%. Five-year biochemical control was 73.8% for non-CRPC and 22% for CRPC cases (0.001). Including and excluding CRPC cases, early treatment after failure vs. delayed treatment was significantly better (p0.05). Chronic adverse events were seen in few patients, with genitourinary Grade 3 toxicity of 8.7% and no genitourinary Grade 4 or gastrointestinal Grade 3 or higher toxicities.A subset of failures after definitive radiation is local in nature, and excellent control is possible with salvage brachytherapy. |
| Databáze: | OpenAIRE |
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