| Autor: |
Kilian E. Salerno, Baris Turkbey, Liza Lindenberg, Esther Mena, Erica E. Schott, Alexandra K. Brennan, Soumyajit Roy, Uma Shankavaram, Krishnan Patel, Theresa Cooley-Zgela, Yolanda McKinney, Bradford J. Wood, Peter A. Pinto, Peter Choyke, Deborah E. Citrin |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Brachytherapy |
| ISSN: |
1538-4721 |
| DOI: |
10.1016/j.brachy.2022.03.009 |
| Popis: |
PURPOSE/OBJECTIVE(S): This study describes the pattern of failure in patients with biochemical (BCR) recurrence after low-dose-rate (LDR) brachytherapy as a component of definitive treatment for prostate cancer. METHODS: Patients with BCR after LDR brachytherapy ± external beam radiation therapy (EBRT) were enrolled on prospective IRB approved advanced imaging protocols. Patients underwent 3T multiparametric MRI (mpMRI); a subset underwent prostate specific membrane antigen (PSMA)-based PET/CT. Pathologic confirmation was obtained unless contraindicated. RESULTS: Between January 2011 and April 2021, 51 patients with BCR after brachytherapy (n = 36) or brachytherapy + EBRT (n = 15) underwent mpMRI and were included in this analysis. Of 38 patients with available dosimetry, only two had D90 < 90%. The prostate and seminal vesicles were a site of failure in 66.7% (n = 34) and 39.2% (n = 20), respectively. PET/CT (n = 32 patients) more often identified lesions pelvic lymph nodes (50%; n = 16) and distant metastases (18.8%; n = 6), than mpMRI. Isolated nodal disease (9.8%; n = 5) and distant metastases (n = 1) without local recurrence were uncommon. Recurrence within the prostate was located in the transition zone in 48.5%, central or midline in 45.5%, and anterior in 36.4% of patients. CONCLUSION: In this cohort of patients with BCR after LDR brachytherapy ± EBRT, the predominant recurrence pattern was local (prostate ± seminal vesicles) with frequent occurrence in the anterior prostate and transition zone. mpMRI and PSMA PET/CT provided complementary information to localize sites of recurrence, with PSMA PET/CT often confirming mpMRI findings and identifying occult nodal or distant metastases. Published by Elsevier Inc. on behalf of American Brachytherapy Society. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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