Conclusion: Salvage HDR brachytherapy for recurrent prostate cancer is feasible with excellent short term biochemical control, although longer follow-up is needed to better assess its efficiency. As it was expected, it is mostly associated with genitourinary toxicities and low GI toxicities, with an initial rise in the IPSS score followed by a slow decrease over the next 36 months. Urethral strictures were reported in 3/36 patients. Prostate necrosis occured in one patient after urological manipulations, meaning these should be minimized as much as possible in patients who underwent salvage HDR brachytherapy. If these results are confirmed with longer follow-up, HDR brachytherapy could become an excellent option for selected patients with recurrent prostate cancer who could avoid the long term use of ADT.
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