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Second salvage treatment for local recurrence of prostate cancer using high-dose-rate brachytherapy: a case report.

Claren A, Gautier M, Feuillade J, Falk AT, Levi JM - J Contemp Brachytherapy (2015)

Bottom Line: The HDRB showed an advantage on bone irradiation including femoral heads and the volume receiving 0.5 Gy (EQD2 = 1 Gy with α/β = 3).A third local treatment with good tolerance could be a therapeutic option in case of a second local prostate cancer recurrence in order to delay, as long as possible, the chemical castration.Both techniques (HDRB and SRS) seem valid and should be chosen based on the availability and experience in a treatment center.

View Article: PubMed Central - PubMed

Affiliation: Unit of Radiation Oncology.

ABSTRACT

Purpose: Currently, there are no recommendations for the management of a second local recurrence of prostate adenocarcinoma except for the introduction of androgen deprivation therapy (ADT).

Case report: A 69-year-old man underwent a third salvage local treatment with high-dose-rate brachytherapy (HDRB), for a second biochemical relapse for local recurrence. Thirty-five Grays in 5 fractions were delivered on the whole prostate extended to the proximal part of left seminal vesicle. Given the availability of new treatment techniques in our radiation therapy department, a dosimetric comparison between HDRB and stereoatactic radiosurgery (SRS) was performed.

Results: Immediate tolerance of HDRB was acceptable with achievement of prostate specific antigen (PSA) nadir in 24 months (0.03 ng/ml). Observed late toxicities were only grade 2 urinary incontinence. Dosimetric comparison showed a slight advantage on clinical target volume coverage and rectum protection for the SRS. The HDRB showed an advantage on bone irradiation including femoral heads and the volume receiving 0.5 Gy (EQD2 = 1 Gy with α/β = 3).

Conclusions: A third local treatment with good tolerance could be a therapeutic option in case of a second local prostate cancer recurrence in order to delay, as long as possible, the chemical castration. Both techniques (HDRB and SRS) seem valid and should be chosen based on the availability and experience in a treatment center.

No MeSH data available.


Related in: MedlinePlus

Prostatic dose-distribution analysis on CT-scan axial slices for each treatment type. Prescribed dose: 35 Gy in 5 fractions. A) High-dose-rate brachytherapy. B) Stereotactic radiosurgery
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Figure 0003: Prostatic dose-distribution analysis on CT-scan axial slices for each treatment type. Prescribed dose: 35 Gy in 5 fractions. A) High-dose-rate brachytherapy. B) Stereotactic radiosurgery

Mentions: Dosimetric results related to HDRB are detailed in Table 1. The comparison of the two irradiation techniques, on the same CT-scan, was based on: percentage of the CTV receiving 100% of the dose (CTV V100%); dose delivered to 90% of the CTV (CTV D90); percentage of the urethra volume receiving 115% (V115%) of the prescribed dose; dose delivered to 0.1 cc, 1 cc and 2 cc of the urethra; percentage of the rectal volume receiving 90% (V90%) of the prescribed dose; dose delivered to 0.1 cc, 1 cc and 2 cc the rectum; median dose delivered to right and left femoral heads and volume of the 0.5 Gy isodose (EQD2α/β3 = 1 Gy), intimately linked to the integral dose ([Total volume receiving 0.5 Gy] – [CTV + OARs]) (Table 2 and Fig. 3).


Second salvage treatment for local recurrence of prostate cancer using high-dose-rate brachytherapy: a case report.

Claren A, Gautier M, Feuillade J, Falk AT, Levi JM - J Contemp Brachytherapy (2015)

Prostatic dose-distribution analysis on CT-scan axial slices for each treatment type. Prescribed dose: 35 Gy in 5 fractions. A) High-dose-rate brachytherapy. B) Stereotactic radiosurgery
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4499512&req=5

Figure 0003: Prostatic dose-distribution analysis on CT-scan axial slices for each treatment type. Prescribed dose: 35 Gy in 5 fractions. A) High-dose-rate brachytherapy. B) Stereotactic radiosurgery
Mentions: Dosimetric results related to HDRB are detailed in Table 1. The comparison of the two irradiation techniques, on the same CT-scan, was based on: percentage of the CTV receiving 100% of the dose (CTV V100%); dose delivered to 90% of the CTV (CTV D90); percentage of the urethra volume receiving 115% (V115%) of the prescribed dose; dose delivered to 0.1 cc, 1 cc and 2 cc of the urethra; percentage of the rectal volume receiving 90% (V90%) of the prescribed dose; dose delivered to 0.1 cc, 1 cc and 2 cc the rectum; median dose delivered to right and left femoral heads and volume of the 0.5 Gy isodose (EQD2α/β3 = 1 Gy), intimately linked to the integral dose ([Total volume receiving 0.5 Gy] – [CTV + OARs]) (Table 2 and Fig. 3).

Bottom Line: The HDRB showed an advantage on bone irradiation including femoral heads and the volume receiving 0.5 Gy (EQD2 = 1 Gy with α/β = 3).A third local treatment with good tolerance could be a therapeutic option in case of a second local prostate cancer recurrence in order to delay, as long as possible, the chemical castration.Both techniques (HDRB and SRS) seem valid and should be chosen based on the availability and experience in a treatment center.

View Article: PubMed Central - PubMed

Affiliation: Unit of Radiation Oncology.

ABSTRACT

Purpose: Currently, there are no recommendations for the management of a second local recurrence of prostate adenocarcinoma except for the introduction of androgen deprivation therapy (ADT).

Case report: A 69-year-old man underwent a third salvage local treatment with high-dose-rate brachytherapy (HDRB), for a second biochemical relapse for local recurrence. Thirty-five Grays in 5 fractions were delivered on the whole prostate extended to the proximal part of left seminal vesicle. Given the availability of new treatment techniques in our radiation therapy department, a dosimetric comparison between HDRB and stereoatactic radiosurgery (SRS) was performed.

Results: Immediate tolerance of HDRB was acceptable with achievement of prostate specific antigen (PSA) nadir in 24 months (0.03 ng/ml). Observed late toxicities were only grade 2 urinary incontinence. Dosimetric comparison showed a slight advantage on clinical target volume coverage and rectum protection for the SRS. The HDRB showed an advantage on bone irradiation including femoral heads and the volume receiving 0.5 Gy (EQD2 = 1 Gy with α/β = 3).

Conclusions: A third local treatment with good tolerance could be a therapeutic option in case of a second local prostate cancer recurrence in order to delay, as long as possible, the chemical castration. Both techniques (HDRB and SRS) seem valid and should be chosen based on the availability and experience in a treatment center.

No MeSH data available.


Related in: MedlinePlus