Highlights
- •We retrospectively analyzed a cohort of 11 patients with a history of prior low dose rate brachytherapy who were treated with homogeneously dosed salvage stereotactic body radiotherapy (SBRT).
- •Three-year progression-free survival was 70.1%, while 3-year overall survival was 100%.
- •Late grade 2 and 3 genitourinary toxicity rates were 36.4% and 9.1%, respectively. Late grade 2 and 3 gastrointestinal toxicity rates were 0% and 9.1%, respectively.
- •Homogeneously dosed prostate SBRT can serve as a safe and effective salvage treatment for local recurrences following low dose rate (LDR) brachytherapy.
Abstract
Introduction
We set out to evaluate the safety and efficacy of homogeneously dosed salvage stereotactic
body radiation therapy (SBRT) for intraprostatic recurrences following low dose rate
(LDR) brachytherapy.
Patients and Methods
An institutional prostate SBRT database was interrogated for patients treated between
January 2018 and December 2021 with salvage SBRT for intraprostatic recurrences who
were previously treated with LDR brachytherapy. Patients received 30 to 34 Gy in 5
fractions to the prostate with a simultaneous integrated boost of 34 to 37.5 Gy to
gross disease. The maximum urethral dose allowed was 34 Gy. Toxicities were graded
using Common Terminology Criteria for Adverse Events, version 5.0.
Results
Eleven patients met our study's inclusion criteria with a median follow-up time of
37.9 months (range, 24.3-51.8 months). Median time between LDR brachytherapy and salvage
SBRT was 7 years (range, 2-11 years) with a median PSA of 3.15 ng/mL (range, 0.90-9.83)
at the time of salvage radiation. All 11 patients were alive at the time of last follow-up.
Our 3-year Kaplan-Meier progression-free survival rate was 70.1%. Median time to recurrence
was 24.1 months (range, 18.7-29.7 months). Late (≥3 months) grade 1, 2, and 3 urinary
toxicity rates were 27.3%, 36.4%, and 9.1%, respectively. Late (≥3 months) grade 1,
2, and 3 gastrointestinal toxicity rates were 18.2%, 0%, and 9.1%, respectively.
Conclusion
Homogeneous salvage SBRT to the prostate with urethral dose minimization has a favorable
safety and efficacy profile for treating intra-prostatic recurrences following LDR
brachytherapy. This may represent an ideal form of salvage SBRT for re-irradiation.
Keywords
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References
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Article info
Publication history
Published online: January 17, 2023
Accepted:
January 15,
2023
Received in revised form:
January 11,
2023
Received:
December 9,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
