Skip to main content

Advertisement

SpringerLink
Log in

Reirradiation salvage radiotherapy for recurrent prostate cancer after primary low-dose brachytherapy

  • RESEARCH ARTICLE
  • Published:
Clinical and Translational Oncology Aims and scope Submit manuscript

Abstract

Purpose

Local recurrence of prostate cancer after low-dose rate brachytherapy is a clinical problem with limited salvage treatment options. This prospective study evaluated the tolerability and outcome of salvage external beam radiation therapy (S-EBRT) for locally recurrent prostate cancer after primary low-dose rate prostate brachytherapy (LDR-BT).

Materials and methods

Between October 2012 and 2022, 18 patients with biopsy-proven locally recurrent prostate cancer after primary LDR-BT and received S-EBRT. We evaluated biochemical failure (BF), overall survival (OS) and acute/late gastrointestinal and urinary toxicities (CTCAE v5.0 or CTCAE v4, only before 2017).

Results

Median follow-up was 32 months (range, 5–124). The median age was at S-EBRT 68 years (range 59–79). 34% (6/18) were low risk, 44% (8/18) intermediate risk, 5% (1/18) high risk, and 17% (3/18) not specified. All patients were treated with IMRT/VMAT and received 60 Gy (2.5 Gy/fraction) to the prostate and 40% (7/18) 55.2 Gy (2,3 Gy/fx) to the seminal vesicles. 56% received ADT The 3-year OS and biochemical relapse-free survival after S-EBRT were 100% and 89%, respectively, with a median PSA nadir 0,035 ng/mL (0,01–0,34). Acute cystitis was present in 72% (13/18) of patients (27% of Grade > 2). Urethritis was present in 78% (14/18) patients (16% of cases Grade > 3), and acute rectitis occurred in 22% (4/18) of patients (no cases Grade > 3).

Conclusions

Our data suggest that the treatment of locally recurrent prostate cancer with S-EBRT could provide adequate disease control safely and be used as an additional treatment in the natural history of prostate cancer patients. However, the results are still early and the sample is small; larger studies with longer follow-up would be mandatory.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Arnold M, Karim-Kos HE, Coebergh JW, Byrnes G, Antilla A, Ferlay J, et al. Recent trends in incidence of five common cancers in 26 European countries since 1988: analysis of the European cancer observatory. Eur J Cancer. 2015;51(9):1164–87. https://doi.org/10.1016/j.ejca.2013.09.002. (Epub 2013 Oct 8 PMID: 24120180).

    Article  PubMed  Google Scholar 

  2. Gandaglia G, Leni R, Bray F, Fleshner N, Freedland SJ, Kibel A, et al. Epidemiology and prevention of prostate cancer. Eur Urol Oncol. 2021;4(6):877–92.

    Article  PubMed  Google Scholar 

  3. Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M, et al. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2019;144(8):1941–53.

    Article  CAS  PubMed  Google Scholar 

  4. Cózar JM, Miñana B, Gómez-Veiga F, Rodríguez-Antolín A, Villavicencio H, on behalf of 25 Urology Units, Asociación Española de Urología, et al. (2012) Prostate cancer incidence and newly diagnosed patient profile in Spain in 2010: prostate cancer incidence and patient profile. BJU Int. 2012;110(11b):E701–6.

    Article  PubMed  Google Scholar 

  5. Mottet N, van den Bergh RCN, Briers E, Van den Broeck T, Cumberbatch MG, De Santis M, et al. EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer—2020 update. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol. 2021;79(2):243–62.

    Article  CAS  PubMed  Google Scholar 

  6. Sasaki H, Kido M, Miki K, Kuruma H, Takahashi H, Aoki M, et al. Salvage partial brachytherapy for prostate cancer recurrence after primary brachytherapy: salvage partial brachytherapy. Int J Urol. 2014;21(6):572–7.

    Article  PubMed  Google Scholar 

  7. Henry A, Pieters BR, André Siebert F, Hoskin P. GEC-ESTRO ACROP prostate brachytherapy guidelines. Radiother Oncol. 2022;167:244–51.

    Article  PubMed  Google Scholar 

  8. Peters M, Moman MR, van der Poel HG, Vergunst H, de Jong IJ, Vijverberg PLM, et al. Patterns of outcome and toxicity after salvage prostatectomy, salvage cryosurgery and salvage brachytherapy for prostate cancer recurrences after radiation therapy: a multi-center experience and literature review. World J Urol. 2013;31(2):403–9.

    Article  PubMed  Google Scholar 

  9. Suh J, Jung JH, Jeong CW, Lee SE, Lee E, Ku JH, et al. Long-term oncologic outcomes after radical prostatectomy in clinically localized prostate cancer: 10 year follow-up in Korea. Investig Clin Urol. 2020;61(3):269.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Arenas Prat M, Ferrer Albiach C. (2021) Libro blanco de la oncología radioterápica en España

  11. Hostiou T, Gelet A, Chapelon JY, Rouvière O, Mège-Lechevalier F, Lafon C, et al. Salvage high-intensity focused ultrasound for locally recurrent prostate cancer after low-dose-rate brachytherapy: oncological and functional outcomes. BJU Int. 2019;124(5):746–57. https://doi.org/10.1111/bju.14838. (Epub 2019 Jul 2 PMID: 31148367).

    Article  PubMed  Google Scholar 

  12. Henríquez I, Sancho G, Hervás A, Guix B, Pera J, Gutierrez C, et al. Salvage brachytherapy in prostate local recurrence after radiation therapy: predicting factors for control and toxicity. Radiat Oncol. 2014;9(1):102.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Valle LF, Lehrer EJ, Markovic D, Elashoff D, Levin-Epstein R, Karnes RJ, et al. A systematic review and meta-analysis of local salvage therapies after radiotherapy for prostate cancer (MASTER). Eur Urol. 2021;80(3):280–92.

    Article  PubMed  Google Scholar 

  14. KvorningTernov K, KragJakobsen A, Bratt O, Ahlgren G. Salvage cryotherapy for local recurrence after radiotherapy for prostate cancer. Scand J Urol. 2015;49(2):115–9. https://doi.org/10.3109/21681805.2014.968869. (Epub 2014 Nov 27 PMID: 25428754).

    Article  CAS  Google Scholar 

  15. Rutenberg MS, Meister M, Amin PP, Hussain A, Naslund MJ, Kwok Y. Salvage external beam radiotherapy for locally recurrent prostate cancer after definitive brachytherapy. Brachytherapy. 2016;15(6):722–9.

    Article  PubMed  Google Scholar 

  16. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021. https://doi.org/10.3322/caac.21660.

    Article  PubMed  Google Scholar 

  17. Mottet N, Van den Bergh RCN, Briers E, Van den Broeck T, Cumberbatch MG, De Santis M, et al. EAU-EANM-ESTRO-ESUR-SIOG guidelines on prostate cancer-2020 update. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol. 2021;79(2):243–62. https://doi.org/10.1016/j.eururo.2020.09.042. (Epub 2020 Nov 7 PMID: 33172724).

    Article  CAS  PubMed  Google Scholar 

  18. Maestroni U, Tafuri A, Dinale F, Campobasso D, Antonelli A, Ziglioli F. Oncologic outcome of salvage high-intensity focused ultrasound (HIFU) in radiorecurrent prostate cancer. A systematic review. Acta Biomed. 2021;92(4):e2021191. https://doi.org/10.23750/abm.v92i3.11475. (PMID: 34487074; PMCID: PMC8477121).

    Article  PubMed  PubMed Central  Google Scholar 

  19. Veereman G, Jonckheer P, Desomer A, Van Brabandt H, D’Hont C, Van Velthoven R, et al. Systematic review of the efficacy and safety of high-intensity focussed ultrasound for localised prostate cancer. Eur Urol Focus. 2015;1(2):158–70. https://doi.org/10.1016/j.euf.2015.04.006. (Epub 2015 Jun 6 PMID: 28723429).

    Article  PubMed  Google Scholar 

  20. Hétet JF, Colls P, Pocholle P, Chauveau P, Barré C, Hallouin P (2014) Cryothérapie de rattrapage après radiothérapie prostatique: principes, indications, sélection des patients, résultats oncologiques et morbidité [Salvage cryotherapy for recurrent prostate cancer after radiotherapy failure: principles, indications, patient selection, oncological results and morbidity]. Cancer Radiother. 18(7): 701-8. French. doi: https://doi.org/10.1016/j.canrad.2014.04.002. Epub 2014 Jun 6. PMID: 24910288

  21. Nguyen PL, D’Amico AV, Lee AK, Suh WW. Patient selection, cancer control, and complications after salvage local therapy for postradiation prostate-specific antigen failure: a systematic review of the literature. Cancer. 2007. https://doi.org/10.1002/cncr.22941.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Lam JS, Belldegrun AS. Salvage cryosurgery of the prostate after radiation failure. Rev Urol. 2004;6(Suppl 4):S27-36 (PMID: 16985867; PMCID: PMC1550974).

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, University Hospital Virgen del Rocío, Manuel Siurot Avenue, S/N., 41013, Seville, Spain

    Óscar Muñoz Muñoz, Elías Gomis Sellés, Blas David Delgado León, José Luis López Guerra & Patricia Cabrera Roldán

  2. Department of Medical Physiology and Biophysics, Medical Radiation Physics, University of Seville, University Hospital Virgen del Rocío, Seville, Spain

    Juan Carlos Mateos Perez

  3. Department of Medical Radiation Physics, University Hospital Virgen del Rocío, Seville, Spain

    Montserrat Baeza Trujillo & Maria Perucha Ortega

Authors
  1. Óscar Muñoz Muñoz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elías Gomis Sellés
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Blas David Delgado León
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Juan Carlos Mateos Perez
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Montserrat Baeza Trujillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maria Perucha Ortega
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. José Luis López Guerra
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Patricia Cabrera Roldán
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to José Luis López Guerra.

Ethics declarations

Conflict of interest

All authors have read and agreed with the content of the submission, and they have no affiliations with or involvement in any organization or entity with any financial interest or nonfinancial interest in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and written informed consent was obtained from all subjects. All data were de-identified, and no names or identifying information were revealed.

Informed consent

This study was approved by our institutional review board and the requirement for informed patient consent was waived due to the retrospective nature of the study and written informed consent was obtained from all subjects.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 21 KB)

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Muñoz Muñoz, Ó., Gomis Sellés, E., Delgado León, B.D. et al. Reirradiation salvage radiotherapy for recurrent prostate cancer after primary low-dose brachytherapy. Clin Transl Oncol 26, 872–879 (2024). https://doi.org/10.1007/s12094-023-03315-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12094-023-03315-1

Keywords

Search

Navigation