Quality of Life After Salvage Cryotherapy: The Impact of Treatment Parameters

Perrotte, Paul; Litwin, Mark S.; McGuire, Edward J.; Scott, Shellie M.; Eschenbach, Andrew C. von; Pisters, Louis L.

doi:10.1016/s0022-5347(05)68569-2

Cited by 85 publications

(52 citation statements)

References 16 publications

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“…5% [32] , while prior transurethral resection of the prostate [23] and lack of a urethral warming catheter [28] increase the risk. The incidence of urethral sloughing (0-5%), persistent perineal pain (4-14%) and urinary retention (2-21%) also appears to be lower with third-generation systems, especially when a urethral warming catheter is used [34] . According to our experience, post-cryotherapy persistent perineal pain must be included in the context of preoperative patient counselling.…”

Section: Discussionmentioning

confidence: 99%

Third-Generation Salvage Cryotherapy for Radiorecurrent Prostate Cancer: A Centre’s Experience

Philippou

Yap²,

Chinegwundoh³

2012

Urol Int

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Introduction: The experience of a tertiary centre in the management of recurrent prostate cancer after radiotherapy by salvage cryotherapy is presented. Patients and Methods: Between February 2006 and August 2008, 19 patients underwent salvage cryotherapy for radiorecurrent prostate cancer. Post-radiotherapy recurrence was confirmed by prostatic biopsy. The ‘Phoenix definition’ was used to define biochemical failure after salvage cryotherapy. Results: The mean age at cryotherapy was 69.2 years and the mean time from radiotherapy to cryotherapy was 72.3 months. Patient characteristics prior to cryotherapy included a mean PSA level of 6.84 ng/ml and a median Gleason score of 7. The mean post-cryotherapy follow-up was 33.3 months. The 2-year biochemical disease-free survival rate was 58%. The median post-cryotherapy PSA nadir was 0.20 ng/ml (range 0.005–8.260). There were no procedure-related or cancer-related deaths. Complications included incontinence (10.5%), erectile dysfunction (89%) and fistula formation (5.3%). Conclusions: The relatively high rates of biochemical response support the use of cryotherapy as a salvage procedure for radiorecurrent prostate cancer.

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Section: Discussionmentioning

confidence: 99%

Third-Generation Salvage Cryotherapy for Radiorecurrent Prostate Cancer: A Centre’s Experience

Philippou

Yap²,

Chinegwundoh³

2012

Urol Int

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“…Of the three patients who developed Grade 3 urinary toxicity, two were characterized at baseline as having Grade 2 symptoms, and one patient was classified as having Grade 1 symptoms at baseline. The median IPSS at baseline was 6 (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17], and the median IPSS at last followup was 12 (range, 1-30). Resolution of an elevated IPSS was seen in 41% of patients (returned within 2 points of baseline) within a median time of 4.5 months.…”

Section: Toxicity Outcomesmentioning

confidence: 99%

A Phase II Study of Salvage High-Dose-Rate Brachytherapy for the Treatment of Locally Recurrent Prostate Cancer after Definitive External Beam Radiotherapy

et al. 2013

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PURPOSE-We report the toxicity and biochemical tumor control outcome of a prospective Phase II study using high-dose-rate brachytherapy (HDR) alone as a salvage therapy for recurrent disease after external beam radiotherapy (EBRT).METHODS-Forty-two patients with biopsy-proven recurrence were enrolled on a Phase II study of salvage HDR monotherapy using iridium-192. Median pretreatment EBRT dose was 8100 cGy (6840-8640 cGy) and the median time from completion of EBRT to salvage HDR was 73 months. The protocol prescription dose of 3200 cGy was delivered in four fractions over 30 hours in a single insertion. Median followup after salvage HDR was 36 months (6-67 months). RESULTS-The actuarial prostate-specific antigen biochemical relapse-free survival and distant metastases-free survival rates at 5 years were 68.5% and 81.5%, respectively. Cause-specific survival was 90.3%. Late genitourinary Grade 1and 2 toxicities were found in 38% and 48%, respectively, and one patient developed Grade 3 urinary incontinence. Late Grade 1 and 2 gastrointestinal toxicity was noted in 17% and 8% of patients, respectively. Three patients (7%) developed Grade 2 late urinary toxicity (urethral stricture), which were corrected with urethral dilatation, and one patient developed Grade 3 urinary incontinence. No Grade 4 toxicities were observed.CONCLUSIONS-Genitourinary toxicity was the most commonly encountered toxicity observed after salvage HDR but severe toxicities were uncommon. Salvage HDR is an effective and welltolerated modality for locally recurrent prostate cancer and should be considered even for patients who have previously been treated with ultra-high dose levels of EBRT.Open access under CC BY-NC-ND license.

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“…A study of salvage cryotherapy has recently been published. 91 The data support the need for urethral warming with respect to several aspects of quality of life and the authors conclude that salvage cryotherapy is not superior to salvage prostatectomy when considering morbidity. Patients should be made aware of these issues and the decision-making process should weigh these factors against potential bene®ts in prognosis.…”

Section: Morbidity From Secondary Treatmentmentioning

confidence: 73%

Local therapy for prostate-specific antigen recurrence after definitive treatment

Meng

Carroll

2001

Prostate Cancer Prostatic Dis

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Quality of Life After Salvage Cryotherapy: The Impact of Treatment Parameters

Cited by 85 publications

References 16 publications

Third-Generation Salvage Cryotherapy for Radiorecurrent Prostate Cancer: A Centre’s Experience

Third-Generation Salvage Cryotherapy for Radiorecurrent Prostate Cancer: A Centre’s Experience

A Phase II Study of Salvage High-Dose-Rate Brachytherapy for the Treatment of Locally Recurrent Prostate Cancer after Definitive External Beam Radiotherapy

Local therapy for prostate-specific antigen recurrence after definitive treatment

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