The following is a summary of “Reirradiation salvage radiotherapy for recurrent prostate cancer after primary low-dose brachytherapy,” published in the September 2023 issue of Oncology by Muñoz et al.

Local prostate cancer recurrence after low-dose brachytherapy is a problem with few treatment options. Researchers performed a prospective study to evaluate the safety and effectiveness of salvage external beam radiation therapy (S-EBRT) for locally recurrent prostate cancer after low-dose-rate prostate brachytherapy (LDR-BT). 

The study included 18 patients with locally recurrent prostate cancer confirmed by biopsy following initial LDR-BT who subsequently received S-EBRT. Their evaluation focused on biochemical failure (BF), overall survival (OS), and the assessment of acute and late gastrointestinal and urinary toxicities (CTCAE v5.0 or CTCAE v4, only before 2017).

The median follow-up was 32 months (range, 5-124). The median age was 68 at S-EBRT (range 59-79).  About 34% (6/18) were at low risk, 44% (8/18) at intermediate risk, 5% (1/18) at high risk, and 17% (3/18) were 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. About 56% of patients received ADT. The 3-year OS and biochemical relapse-free survival after S-EBRT were 100% and 89%, respectively, with a median PSA nadir of 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) of patients (16% of cases Grade > 3), and acute rectitis occurred in 22% (4/18) of patients (no cases Grade > 3).

The study concluded that S-EBRT may be a safe and effective treatment option for locally recurrent prostate cancer, but further studies are needed.

Source: pubmed.ncbi.nlm.nih.gov/37672205/