Oral & Poster Presentation – Abstracts Archive

UK & Ireland Prostate Brachytherapy Conference 2013

Abstract number 3

Outcome of Patients Treated with Salvage Brachytherapy for Local Failure after Initial External Beam Radiotherapy for Prostate Cancer: Galway Experience

Jamsari Khalid
Research Fellow in Prostate Brachytherapy, Galway University Hospital
Anysja Zuchora
Medical Physics and Bioengineering, Galway University Hospital
Louise Fahy
Medical Physics and Bioengineering, Galway University Hospital
Peter Woulfe
Medical Physics, Galway Clinic
Claire Dooley
Medical Physics, Galway Clinic
Professor Frank Sullivan
Professor of Radiation Oncology, Galway University Hospital

Aims/Introduction: To assess our experience with salvage brachytherapy (SBT) as a possible therapeutic approach for local recurrence after definitive external radiotherapy (EBRT) for prostate cancer.

Materials/Methods: Between 2009 and 2013 we have treated 14 patients in the Galway hospitals with salvage brachytherapy whom had received prior EBRT. Primary outcomes were prostate specific antigen (PSA) control. Secondary outcomes were International Prostate Symptom Score (IPSS) and toxicities were graded using CTC v3.0. The planning dosimetry was also reviewed.

Results: At the time of salvage therapy the median time to the diagnosis of local recurrence was 8 years, the median PSA was 4.71ng/ml, and all the patient were staged at <T2c. At salvage the GS (Gleason score) 6 were five, GS 7 were three and GS 8 were six patients. Nine patients had androgen deprivation therapy before salvage and six did not. The median dose EBRT were equivalent dose at 2Gy per fraction (EQD2) of 70Gy. Median follow up after salvage were 25.5 months (4-52). Mean IPSS at salvage and after salvage were at 4 and 7 respectively. There were one failure noted thus far with mean PSA post implant of 1.6ng/ml and median of 0.33ng/ml. Complications include one grade 2 rectal bleeding and one grade 2 haematuria. The brachytherapy prescription was120Gy to the prostate. The mean prostate volume before treatment was 18.03 ± 5.4cc. The mean urethra implant dose D30 was 146 ± 15.7Gy. The day 30 post implant dosimetry D90 was 136.1 ± 13.8Gy, V100 was 95.1 ± 4.5%, V150 was 54.9 ± 16.1% and the Rectum dose 2cc volume was 73.4 ± 16.7Gy.

Conclusions: SBT appears to provide excellent cancer control rate with acceptable rate of rectal and urinary toxicity even after EBRT. An extended follow up is necessary to determine long term success and safety of SBT.