591 LOW DOSE BRACHYTHERAPY WITH I125 IN PATIENTS WITH LOCAL PROSTATE CANCER RECURRENCE AFTER RADICAL PROSTATECTOMY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized III1 Apr 2010591 LOW DOSE BRACHYTHERAPY WITH I125 IN PATIENTS WITH LOCAL PROSTATE CANCER RECURRENCE AFTER RADICAL PROSTATECTOMY F.G. Gómez Veiga, A. Marino, I. Gómez, L.A. Castelo, J. Gonzalez Dacal, S. Breijo, D. Lopez, J. Ponce, A. Candal, and V. Chantada F.G. Gómez VeigaF.G. Gómez Veiga More articles by this author , A. MarinoA. Marino More articles by this author , I. GómezI. Gómez More articles by this author , L.A. CasteloL.A. Castelo More articles by this author , J. Gonzalez DacalJ. Gonzalez Dacal More articles by this author , S. BreijoS. Breijo More articles by this author , D. LopezD. Lopez More articles by this author , J. PonceJ. Ponce More articles by this author , A. CandalA. Candal More articles by this author , and V. ChantadaV. Chantada More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.863AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Treatment for patients with biochemical progression after radical prostatectomy (RP) and suspicion of local recurrence usually consists of external beam radiotherapy. This a valid option, but not exempt from complications, and is demanding in terms of dose adjustment and definition of target volumes. Low dose- brachytherapy (LDB) is an alternative option for patients with localized prostate cancer. The aim of this prospective study was to analyze the capacity of LDB to treat patients with local progression after RP in terms of toxicity and oncologic control METHODS 42 patients were treated for local prostate cancer relapse from April 2004 to July 2009. Median age was 69.2 years(54-76). The pathologic staging after at RP was 1(2.4%) pT0, 5(11.9%) pT2a, 7(16.7%), pT2b, 14(33.3%)pT2c, 11(26.2%) pT3a and 4(9.5%) pT3b. Local progression in all cases was confirmed by positive biopsy. The Gleason score (GS) on control biopsy ranged from 6-9, 20(47.1%) GS 6, 18(42.9%) GS 7 and 4 (9.5%) GS ≥8. Only patients with more than 6 months follow-up were included n=35. The median follow-up was 29.5 months (6-60.5), and median time to biochemical progression 26 months. Median PSA before LDB was 1.9 ng/mL(range 0.24-6.8). Real-time implant was realized using Variseed 7.2 program and Rapid Strand ®seeds were used. Treatment dose planning was for 144 Gy to cover the anastomotic area. Median volume prescription was 10cc (3.1-23), seeds activity 0.48mci, seeds per session 44.4, and median prostate and urethra d90 174Gy and 121G respectively. All patients were assessed for acute and late gastrointestinal (GI) and genitourinary (GU) toxicity as defined by RTOG. Biochemical failure was defined using the Phoenix definition. All cases were hormone naive prior to LDB. RESULTS Median hospital stay was 21h. There were no major perioperative complications. All patients were discharged without urethral catheter. Acute GI and GU complications grade 1 and 2 were 2(5.7%), 1(2.9%) and 14(40%) and 3(8.6%) respectively.Mild previous incontinence improved in 3 patients (8.6%). Late GI and GU complications grade 1 or 2 were 3 (8.8%), 1 (2.9%), and 3 (8.6%) and 1 (2.9%) respectively. With a median follow up of 29.5 months, biochemical relapsed-free survival was 88.6%, 4 patients had biochemical failure and one patient died, related to prostate cancer the cancer- free survival was 97%. CONCLUSIONS Although longer follow up is needed, these promising results, with minimal morbidity and excellent biochemical response, lead us to believe that LDB is a valid salvage option or patients with local relapse after RP A Coruna, Spain© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e232 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information F.G. Gómez Veiga More articles by this author A. Marino More articles by this author I. Gómez More articles by this author L.A. Castelo More articles by this author J. Gonzalez Dacal More articles by this author S. Breijo More articles by this author D. Lopez More articles by this author J. Ponce More articles by this author A. Candal More articles by this author V. Chantada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...