Feasibility of MR-Guided Partial Permanent Prostate Implant (PPI) Salvage of Localized Recurrence after Initial PPI (iPPI)-treated Prostate Cancer (PCa)

Abstract

Thirty percent of patients have locally recurrent PCa after iPPI and can be treated palliatively with hormone therapy (HT) or curatively with cryotherapy, surgery, or brachytherapy (BT). Because (1) exact location of recurrent tumor is generally unknown, (2) iPPI causes volumetric changes over time, and (3) difficulty recreating iPPI isodose coverage, conventional PPI salvage involves the entire prostate (EP), with GI/GU Grade 3+ toxicity ∼30% and ∼13% requiring colostomy/urostomy for fistulas. Our goal was to assess feasibility, control, and toxicity in eligible patients for partial salvage PPI (sPPI) using MRI/MR-spectroscopy and MR deformation.