Salvage brachytherapy in prostate local recurrence after radiation therapy : Predicting factors for control and toxicity
Henríquez, Iván (Institut d'Investigació Sanitària Pere Virgili)
Sancho-Pardo, Gemma (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Hervás, Asunción (Hospital Universitario Ramón y Cajal (Madrid))
Guix, Benjamin (Insitut Mèdic d'Oncologia a Barcelona)
Pera, Joan (Institut Catalâ d'Oncologia)
Gutierrez, Cristina (Institut Catalâ d'Oncologia)
Abuchaibe, Oscar (Centro de Cancer y Enfermedades Hematológicas - Virgilio Galvis Ramirez)
Martínez-Monge, Rafael (Clínica Universidad de Navarra)
Tormo, Alejandro (Hospital Universitari i Politècnic La Fe (València))
Polo, Alfredo (Hospital Universitario Ramón y Cajal (Madrid))

Fecha:	2014
Resumen:	Purpose: To evaluate efficacy and toxicity after salvage brachytherapy (BT) in prostate local recurrence after radiation therapy. Methods and materials: Between 1993 and 2007, we retrospectively analyzed 56 consecutively patients (pts) undergoing salvage brachytherapy. After local biopsy-proven recurrence, pts received 145 Gy LDR-BT (37 pts, 66%) or HDR-BT (19 pts, 34%) in different dose levels according to biological equivalent doses (BED). By the time of salvage BT, only 15 pts (27%) received ADT. Univariate and multivariate analyses were performed to identify predictors of biochemical control and toxicities. Acute and late genitourinary (GU) and gastrointestinal (GI) toxicities were graded using Common Terminology Criteria for Adverse Events (CTCv3. 0). Results: Median follow-up after salvage BT was 48 months. The 5-year FFbF was 77%. HDR and LDR late grade 3 GU toxicities were observed in 21% and 24%. Late grade 3 GI toxicities were observed in 2% (HDR) and 2. 7% (LDR). On univariate analysis, pre-salvage prostate-specific antigen (PSA) > 10 ng/ml (p = 0. 004), interval to relapse after initial treatment < 24 months (p = 0. 004) and salvage HDR-BT doses BED level < 227 Gy (p = 0. 012) were significant in predicting biochemical failure. On Cox multivariate analysis, pre-salvage PSA, and time to relapse were significant in predicting biochemical failure. HDR-BT BED (α/β 1. 5 Gy) levels ≥ 227 (p = 0. 013), and ADT (p = 0. 049) were significant in predicting grade ≥ 2 urinary toxicity. Conclusions: Prostate BT is an effective salvage modality in some selected prostate local recurrence patients after radiation therapy. Even, we provide some potential predictors of biochemical control and toxicity for prostate salvage BT, further investigation is recommended. © 2014 Henríquez et al. ; licensee BioMed Central Ltd.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Androgen deprivation therapy ; High-dose-rate-brachytherapy ; Low-dose-rate-brachytherapy ; Prostate cancer ; Salvage brachytherapy
Publicado en:	Radiation oncology, Vol. 9 Núm. 1 (30 2014) , p. 102, ISSN 1748-717X

DOI: 10.1186/1748-717X-9-102
PMID: 24885287

8 p, 291.7 KB

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