Prostate Brachytherapy UK & Ireland 11-12 June 2026

Poster Presentation – Abstracts Archive

UK & Ireland Prostate Brachytherapy Conference 2017

Abstract number 12

Salvage prostate High Dose Rate Brachytherapy: Initial Bristol experience

Masson S*; Challapalli A*; Humphrey P*; Savage L*; Brown A*; Bahl A*
*Bristol Cancer Institute/University Hospitals Bristol NHS Foundation Trust

AIMS/INTRODUCTION: High dose-rate (HDR) prostate salvage brachytherapy (salvage HDR), following radical radiotherapy, is a highly conformal radiation technique, delivering minimal dose to adjacent organs. We describe our initial experience in Bristol.

MATERIALS/METHODS: 3 patients who had received radical radiotherapy (74Gy in 37 fractions to prostate +/- seminal vesicles with androgen deprivation therapy (ADT)) received salvage HDR during 2016 and 2017. Catheters were placed transperineally, using trans-rectal ultrasound. 19Gray/single fraction was prescribed to the planning target volume (PTV) (prostate + isotropic 3mm margin). Recurrences were biopsy proven. For two patients, 11CCholine-PET demonstrated prostatic uptake only. Patient 3 had standard staging CT and bone scans excluding visible metastases. Presenting characteristics are described at (a) original presentation; and (b) time of salvage:

  1. (a) Age 57, T3N0M0 Gleason 3+4, PSA 18ug/L; (b) Age 61, left sided disease; PSA 8.0ug/L;
  2. (a) Age 68, T3aN0M0 Gleason 3+4, PSA not known (b) Age 72, anterior disease, PSA 1.8ug/L (on ADT);
  3. (a) Age 63, T2aN0M0, Gleason 3+3, PSA 17.5ug/L (b) Age 69, right sided disease; PSA 0.6ug/L; (on ADT).

RESULTS: V100 (PTV volumes receiving 100% prescription) were 94.28%, 91.1% and 95.27%
(target 95%), with rectal and urethral doses within tolerance. All patients underwent successful trial without catheter within 24 hours. Initial urinary frequency improved to baseline by 8 weeks in 2 of 3 cases; patient 1 has ongoing Grade 1 GU toxicity at 12 months. No bowel or sexual function toxicity was observed.PSA fell in all cases initially. A subsequent increase has occurred in Patient 1 (9 and 12 months; 4.6 ug/L, 2.16 ug/L nadir).

CONCLUSION: Salvage HDR is feasible with acceptable dosimetry, albeit PTV coverage is reduced compared with ‘non-salvage’ HDR, usually to allow rectal sparing. Biochemical responses are observed, with further follow-up required to determine signifi cance of rising PSA at 9-12 months.