Jure Murgic1, Gerard Morton1, Andrew Loblaw1, Laura D'Alimonte1, Ananth Ravi2, Matt Wronski2, Melanie Davidson2, Masoom Haider3, Kristina Commisso4, Liying Zhang4, Hans T Chung5. 1. Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada. 2. Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada; Department of Medical Physics, Odette Cancer Center, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada. 3. Department of Medical Imaging, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada. 4. Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada. 5. Department of Radiation Oncology, Odette Cancer Center, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada. Electronic address: hans.chung@sunnybrook.ca.
Abstract
PURPOSE: Although increasing data support whole-gland salvage therapy for recurrent prostate cancer, toxicity remains a significant concern. We hypothesized that focal therapy, treating only a portion of the prostate containing recurrent disease, might be equally effective and associated with less toxicity. The objectives of this prospective study were to explore the toxicities, quality of life, and efficacy of focal salvage high-dose-rate (HDR) brachytherapy in patients with multiparametric magnetic resonance imaging (MRI)-visible, biopsy-confirmed local recurrence after previous definitive external beam radiation therapy. MATERIALS AND METHODS: Fifteen patients with locally recurrent prostate cancer after external beam radiation therapy were enrolled in this prospective study. Patients were treated with ultrasound-based HDR brachytherapy with a prescription dose of 27 Gy divided in 2 implants, separated by 1 week, to the clinical target volume, which was defined as the quadrant of the prostate where the MRI-visible recurrent lesion was located. Toxicity, quality of life, and biochemical outcomes were analyzed. Postsalvage MRI was performed to assess radiation therapy response. RESULTS: Median follow-up was 36 months. The median size of the recurrence on MRI was 9 mm (range, 7-20 mm), and clinical target volume at the time of HDR was 6.1 mL (range, 2.2-16.1 mL). Only one grade 3 genitourinary toxicity event was observed. No urinary retention was observed. Three-year prostate-specific antigen failure-free rate was 61%. There was no significant change in Expanded Prostate Cancer Index Composite urinary or bowel domains over time. Of the 14 patients who had a post-HDR MRI, 12 had a treatment response. CONCLUSIONS: Our results suggest that focal salvage HDR brachytherapy is well tolerated and promising. External validation is needed.
PURPOSE: Although increasing data support whole-gland salvage therapy for recurrent prostate cancer, toxicity remains a significant concern. We hypothesized that focal therapy, treating only a portion of the prostate containing recurrent disease, might be equally effective and associated with less toxicity. The objectives of this prospective study were to explore the toxicities, quality of life, and efficacy of focal salvage high-dose-rate (HDR) brachytherapy in patients with multiparametric magnetic resonance imaging (MRI)-visible, biopsy-confirmed local recurrence after previous definitive external beam radiation therapy. MATERIALS AND METHODS: Fifteen patients with locally recurrent prostate cancer after external beam radiation therapy were enrolled in this prospective study. Patients were treated with ultrasound-based HDR brachytherapy with a prescription dose of 27 Gy divided in 2 implants, separated by 1 week, to the clinical target volume, which was defined as the quadrant of the prostate where the MRI-visible recurrent lesion was located. Toxicity, quality of life, and biochemical outcomes were analyzed. Postsalvage MRI was performed to assess radiation therapy response. RESULTS: Median follow-up was 36 months. The median size of the recurrence on MRI was 9 mm (range, 7-20 mm), and clinical target volume at the time of HDR was 6.1 mL (range, 2.2-16.1 mL). Only one grade 3 genitourinary toxicity event was observed. No urinary retention was observed. Three-year prostate-specific antigen failure-free rate was 61%. There was no significant change in Expanded Prostate Cancer Index Composite urinary or bowel domains over time. Of the 14 patients who had a post-HDR MRI, 12 had a treatment response. CONCLUSIONS: Our results suggest that focal salvage HDR brachytherapy is well tolerated and promising. External validation is needed.
Authors: Randall J Brenneman; Edward Soffen; Hiram A Gay; Peter F Orio; John P Christodouleas; John C Baumann; Brian C Baumann Journal: Transl Androl Urol Date: 2019-07
Authors: Marieke van Son; Evelyn Monninkhof; Max Peters; Jan Lagendijk; Jochem van der Voort van Zyp Journal: Clin Transl Radiat Oncol Date: 2020-10-17
Authors: O Pons-Llanas; J Burgos-Burgos; S Roldan-Ortega; A Conde-Moreno; F Celada-Alvarez; J C Ruiz-Martinez; F Lliso-Valverde; A Tormo-Micó; J Perez-Calatayud; J López-Torrecilla Journal: Rep Pract Oncol Radiother Date: 2020-07-05
Authors: Marieke van Son; Max Peters; Marinus Moerland; Linda Kerkmeijer; Jan Lagendijk; Jochem van der Voort van Zyp Journal: Cancers (Basel) Date: 2018-12-03 Impact factor: 6.639
Authors: Finbar Slevin; Samantha Hodgson; Sree Lakshmi Rodda; Peter Bownes; David Bottomley; Ese Adiotomre; Bashar Al-Qaisieh; Emma Dugdale; Oliver Hulson; Joshua Mason; Jonathan Smith; Ann M Henry Journal: Clin Transl Radiat Oncol Date: 2020-03-27
Authors: Christopher C Khoo; Saiful Miah; Martin J Connor; Joseph Tam; Mathias Winkler; Hashim U Ahmed; Taimur T Shah Journal: Transl Androl Urol Date: 2020-06
Authors: Thomas Willigenburg; Marieke J van Son; Sandrine M G van de Pol; Wietse S C Eppinga; Jan J W Lagendijk; Hans C J de Boer; Marinus A Moerland; Jochem R N van der Voort van Zyp; Max Peters Journal: Clin Transl Radiat Oncol Date: 2021-06-29