No standard treatment exists for locally relapsed prostate cancer after primary external beam radiotherapy with no evidence of distant metastases. Radical prostatectomy, brachytherapy, cryotherapy and high-intensity focused ultrasound are currently used as local salvage treatments. Data on the safety and effectiveness of high dose rate (HDR) brachytherapy in this scenario are limited. We report on a patient who has no evidence of disease and no late urinary or gastrointestinal toxicity 33 months after receiving HDR treatment for recurrent prostate cancer.
ToumaN.J., IzawaJ.I., ChinJ.L.: Current status of local salvage therapies following radiation failure for prostate cancer. J Urol, 173: 373–379, 2005.
3.
BeyerD.C.: Brachytherapy for recurrent prostate cancer after radiation therapy. Semin Radiat Oncol, 13: 158–165, 2003.
4.
AllenG.W., HowardA.R., JarrardD.F., RitterM.A.: Management of prostate cancer recurrences after radiation therapy - Brachytherapy as a salvage option. Cancer, 110: 1405–1416, 2007.
5.
WongW.W., BuskirkS.J., SchildS.E., PrussakK.A., DavisB.J.: Combined prostate brachytherapy and short-term androgen deprivation therapy as salvage therapy for locally recurrent prostate cancer after external beam irradiation. J Urol, 176: 2020–2024, 2006.
6.
LeeH.K., AdamsM.T., MottaJ.: Salvage prostate brachytherapy for localized prostate cancer failure after external beam radiation therapy. Brachytherapy, 7: 17–21, 2008.
7.
LeeB., ShinoharaK., WeinbergV., GottschalkA.R., PouliotJ., RoachM3rd, HsuI.C.: Feasibility of high-dose-rate brachytherapy salvage for local prostate cancer recurrence after radiotherapy: the University of California-San Francisco experience. Int J Radiat Oncol Biol Phys, 67: 1106–1112, 2007.
8.
TharpM., HardacreM., BennettR., JonesW.T., StuhldreherD., VaughtJ.: Prostate high-dose-rate brachytherapy as salvage treatment of local failure after previous external or permanent seed irradiation for prostate cancer. Brachytherapy, 7: 231–236, 2008.
9.
American Society for Therapeutic Radiology and Oncology (ASTRO)Consensus Panel: Consensus Statement: guidelines for PSA following radiation therapy. Int J Radiat Oncol Biol Phys, 37: 1035–1041, 1997.
10.
Memorial Sloan-Kettering CancerCenter prostate nomogram - PSA Doubling Time. Available at http://www.mskcc.org (accessed 27 July, 2009).
11.
FowlerJ., ChappellR., RitterM.: Is alpha/beta for prostate tumors really low?Int J Radiat Oncol Biol Phys, 50: 1021–1031, 2001.
12.
BrennerD.J., HallE.J.: Fractionation and protraction for radiotherapy of prostate carcinoma. Int J Radiat Oncol Biol Phys, 43: 1095–1101, 1999.
13.
KingC.R., FowlerJ.F.: A simple analytic derivation suggests that prostate cancer alpha/beta ratio is low. Int J Radiat Oncol Biol Phys, 51: 213–214, 2001.
14.
LotanY., StanfieldJ., ChoL.C., SherwoodJ.B., Abdel-AzizK.F., ChangC.H., ForsterK., KabbaniW., HsiehJ.T., ChoyH., TimmermanR.: Efficacy of high dose per fraction radiation for implanted human prostate cancer in a nude mouse model. J Urol, 175: 1932–1936, 2006.
15.
WangJ.Z., LiX.A., YuC.X., DiBiaseS.J.: The low alpha/beta ratio for prostate cancer: what does the clinical outcome of HDR brachytherapy tell us?Int J Radiat Oncol Biol Phys, 57: 1101–1108, 2003.
16.
GrillsI.S., MartinezA.A., HollanderM., HuangR., GoldmanK., ChenP.Y., GustafsonG.S.: High dose rate brachytherapy as prostate cancer monotherapy reduces toxicity compared to low dose rate palladium seeds. J Urol, 171: 1098–1104, 2004.
17.
Lloyd-DaviesR.W., CollinsC.D., SwanA.V.: Carcinoma of prostate treated by radical external beam radiotherapy using hypofractionation. Twenty-two years' experience (1962–1984). Urology, 36: 107–111, 1990.
18.
KupelianP.A., ReddyC.A., KleinE.A., WilloughbyT.R.: Short-course intensity-modulated radiotherapy (70 GY at 2.5 GY per fraction) for localized prostate cancer: preliminary results on late toxicity and quality of life. Int J Radiat Oncol Biol Phys, 51: 988–993, 2001.
19.
FowlerJ.F., NahumA.E., OrtonC.G.: Point/Counterpoint. The best radiotherapy for the treatment of prostate cancer involves hypofractionation. Med Phys, 33: 3081–3084, 2006.
20.
MadsenB.L., HsiR.A., PhamH.T., FowlerJ.F., EsaguiL., CormanJ.: Stereotactic hypofractionated accurate radiotherapy of the prostate (SHARP), 33.5 Gy in five fractions for localized disease: first clinical trial results. Int J Radiat Oncol Biol Phys, 67: 1099–1105, 2007.
21.
CornerC., RojasA.M., BryantL., OstlerP., HoskinP.: A phase II study of high-dose-rate afterloading brachytherapy as monotherapy for the treatment of localized prostate cancer. Int J Radiat Oncol Biol Phys, 72: 441–446, 2008.
22.
YoshiokaY., NoseT., YoshidaK., OhR.J., YamadaY., TanakaE., YamazakiH., InoueT., InoueT.: High-dose-rate brachytherapy as monotherapy for localized prostate cancer: a retrospective analysis with special focus on tolerance and chronic toxicity. Int J Radiat Oncol Biol Phys, 56: 213–220, 2003.
23.
TrottiA., ColevasA.D., SetserA., RuschV., JaquesD., BudachV., LangerC., MurphyB., CumberlinR., ColemanC.N., RubinP.: CTCAE v3.0: Development of a comprehensive grading system for the adverse effects of cancer treatment. Semin Radiat Oncol, 13: 176–181, 2003.