Re-salvage MRI-guided Focal High-dose-rate Brachytherapy for Locally Recurrent Prostate Cancer

Son, Marieke van; Peters, Max; Moerland, Marinus A.; Noteboom, J.L.; Eppinga, Wietse S.C.; Fajardo, Raquel Dávila; Lagendijk, J J W; Zyp, Jochem R. van der Voort van

doi:10.7759/cureus.2429

Cited by 3 publications

(11 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Irreversible electroporation and high-dose rate focal brachytherapy have also been described in a salvage context and do seem feasible after FT failure. However, evidence is scarce and warrants further assessment [22,23].…”

Section: Salvage Re-ablationmentioning

confidence: 99%

Salvage Local Treatments After Focal Therapy for Prostate Cancer

Marra

Valério

Emberton

et al. 2019

European Urology Oncology

View full text Add to dashboard Cite

Context: Whether focal therapy (FT) for prostate cancer (PCa) jeopardizes outcomes of salvage treatments is a matter of debate awaiting to be resolved. Objective: To review the literature investigating oncological and functional outcomes as well as complications of available treatment options for recurrent or residual disease after primary FT. Evidence Acquisition: We performed a non-systematic web search using pubmed, including all articles aiming at assessing relevant outcomes of salvage local treatment after FT failure. Web search was implemented by manual search. When no evidence could be extracted in the FT domain, records dealing with recurrence after whole-gland ablation were considered. Evidence Synthesis: four retrospective series assessed salvage treatments after FT failure evaluating cases of radical prostatectomy (RP) and redo ablation (included patients n=12-22). The studies' quality was low with a high risk of bias. Other options are radiation therapy (RT) and whole gland or focal redo ablations which, however, have only been described after whole-gland ablation. With some exceptions, including sexual function for RP, overall complications, oncological and functional outcomes do seem acceptable not being much worse than those of a primary setting. Important limitations include low level of evidence and absence of standardized criteria for FT, salvage treatment and FT failure. Conclusions: Current evidence shows acceptable outcomes of post-FT salvage options, although this is based on retrospective data. While it seems that FT has minimal impact on salvage treatment results, prospective controlled studies are needed to confirm this preliminary data.

show abstract

Section: Salvage Re-ablationmentioning

confidence: 99%

Salvage Local Treatments After Focal Therapy for Prostate Cancer

Marra

Valério

Emberton

et al. 2019

European Urology Oncology

View full text Add to dashboard Cite

show abstract

“…Although some studies on salvage brachytherapy for LR after radical radiotherapy have been reported, 3 only a few have reported on re-salvage brachytherapy for LR after salvage brachytherapy. 5,6 Maenhout et al 5 reported four cases who underwent re-salvage focal HDR brachytherapy after salvage fLDR brachytherapy, resulting in two of the four cases experiencing no BCR. Moreover, Son et al 6 reported a case who received re-salvage focal HDR brachytherapy for a LR after salvage focal HDR brachytherapy; at the 6-month follow-up, the patient had no BCR and no severe GU/GI toxicities.…”

Section: Discussionmentioning

confidence: 99%

“…5,6 Maenhout et al 5 reported four cases who underwent re-salvage focal HDR brachytherapy after salvage fLDR brachytherapy, resulting in two of the four cases experiencing no BCR. Moreover, Son et al 6 reported a case who received re-salvage focal HDR brachytherapy for a LR after salvage focal HDR brachytherapy; at the 6-month follow-up, the patient had no BCR and no severe GU/GI toxicities. Thus, re-salvage focal brachytherapy after salvage brachytherapy has acceptable oncological outcomes, suggesting that it has potential as a treatment strategy.…”

Section: Discussionmentioning

confidence: 99%

Re‐salvage focal low‐dose rate brachytherapy for local recurrence of prostate cancer after salvage focal low‐dose rate brachytherapy

Nakamoto,

Yoshida,

Shiga

et al. 2023

IJU Case Reports

View full text Add to dashboard Cite

IntroductionSalvage brachytherapy represents an effective treatment for local recurrence of prostate cancer after prior external beam radiotherapy. However, the optimal therapeutic strategies for local recurrence after salvage brachytherapy have not yet been determined.Case presentationWe describe the case of a 77‐year‐old man who underwent re‐salvage focal low‐dose rate brachytherapy for local recurrence after carbon ion radiotherapy and salvage focal low‐dose rate brachytherapy. We performed re‐salvage focal low‐dose rate brachytherapy for the recurrence with a different type of seed, which resulted in a significant reduction in the prostate‐specific antigen level. During the 35‐month follow‐up after re‐salvage focal low‐dose rate brachytherapy, no recurrence of prostate cancer and no severe radiation‐related toxicities were observed.ConclusionOur patient was successfully treated with re‐salvage focal low‐dose rate brachytherapy for local recurrence after salvage focal low‐dose rate brachytherapy. This treatment strategy might be effective for such patients and is not associated with sexual dysfunction or severe adverse events.

show abstract

“…Nowadays, many patients with biochemical recurrence are still treated with (deferred) ADT. 76 However, ADT is a systemic treatment and is associated with significant side effects, such as hot flushes, osteoporosis, loss of libido, erectile dysfunction, and therefore deterioration of quality of life. 77 Moreover, tumour progression under hormonal treatment (i.e.…”

Section: Locally Recurrent Prostate Cancermentioning

confidence: 99%

“…74 This opens up possibilities for re-salvage treatment. 74,76 Watchful waiting can also be a 'treatment' strategy, as in some patients the PSA only tends to increase slowly over time without immediate signs of metastatic disease. In these patients, initiation of systemic treatment can be postponed, withholding them from the toxic systemic effects.…”

Section: Focal Salvage Mri-guided High-dose-rate Brachytherapymentioning

confidence: 99%

MRI-guided stereotactic radiotherapy for localised prostate cancer

Willigenburg¹

View full text Add to dashboard Cite

Although the incidence of prostate cancer is high, improvements in treatments have led to high survival rates in patients with low- and intermediate-risk prostate cancer. Therefore, it is even more important that treatments for these patients are minimally invasive and cause as little side effects as possible. The last decades, radiotherapy treatments have changed significantly. One of the clinically introduced innovations is the MR-Linac, a combination of a linear accelerator and an MRI scanner. This machine allows high-quality imaging before and during treatment and daily treatment plan optimisation based on the changing anatomy. This enables more precise radiotherapy and therefore better sparing of healthy organs, which will potentially lead to less side effects such as urinary complaints and erectile dysfunction. This thesis provides insight into the clinical introduction and first period of prostate cancer treatment on the MR-Linac. In part 1 of this thesis, new workflows and technological developments for MRI-guided prostate cancer treatment are presented, which are aimed at enabling extremely hypofractionated radiotherapy for prostate cancer in one or two treatment fractions. With these new workflows, the irradiated volumes can be reduced significantly. Furthermore, early (patient-reported) outcomes of MRI-guided prostate cancer radiotherapy are investigated within two cohort studies, including the international MOMENTUM study. These clinical results are already promising. Part 2 of this thesis focusses on re-irradiation in patients with recurrent prostate cancer after primary radiotherapy treatment. We present research on the feasibility of so-called single-fraction ‘focal salvage’ radiotherapy using external beam radiotherapy on the MR-Linac. The work presented in this thesis is part of the first steps towards MRI-guided, extremely high-precision radiotherapy treatment for (recurrent) prostate cancer in only one or two treatment sessions.

show abstract

Re-salvage MRI-guided Focal High-dose-rate Brachytherapy for Locally Recurrent Prostate Cancer

Cited by 3 publications

References 10 publications

Salvage Local Treatments After Focal Therapy for Prostate Cancer

Salvage Local Treatments After Focal Therapy for Prostate Cancer

Re‐salvage focal low‐dose rate brachytherapy for local recurrence of prostate cancer after salvage focal low‐dose rate brachytherapy

MRI-guided stereotactic radiotherapy for localised prostate cancer

Contact Info

Product

Resources

About