Salvage brachytherapy in prostate local recurrence after radiation therapy: predicting factors for control and toxicityReportar como inadecuado




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Radiation Oncology

, 9:102

Clinical Radiation Oncology

Abstract

PurposeTo evaluate efficacy and toxicity after salvage brachytherapy BT in prostate local recurrence after radiation therapy.

Methods and materialsBetween 1993 and 2007, we retrospectively analyzed 56 consecutively patients pts undergoing salvage brachytherapy. After local biopsy-proven recurrence, pts received 145 Gy LDR-BT 37 pts, 66% or HDR-BT 19 pts, 34% in different dose levels according to biological equivalent doses BED2 Gy. By the time of salvage BT, only 15 pts 27% received ADT. Univariate and multivariate analyses were performed to identify predictors of biochemical control and toxicities. Acute and late genitourinary GU and gastrointestinal GI toxicities were graded using Common Terminology Criteria for Adverse Events CTCv3.0.

ResultsMedian follow-up after salvage BT was 48 months. The 5-year FFbF was 77%. HDR and LDR late grade 3 GU toxicities were observed in 21% and 24%. Late grade 3 GI toxicities were observed in 2% HDR and 2.7% LDR. On univariate analysis, pre-salvage prostate-specific antigen PSA > 10 ng-ml p = 0.004, interval to relapse after initial treatment < 24 months p = 0.004 and salvage HDR-BT doses BED2 Gy level < 227 Gy p = 0.012 were significant in predicting biochemical failure. On Cox multivariate analysis, pre-salvage PSA, and time to relapse were significant in predicting biochemical failure.

HDR-BT BED2 Gy α-β 1.5 Gy levels ≥ 227 p = 0.013, and ADT p = 0.049 were significant in predicting grade ≥ 2 urinary toxicity.

ConclusionsProstate BT is an effective salvage modality in some selected prostate local recurrence patients after radiation therapy. Even, we provide some potential predictors of biochemical control and toxicity for prostate salvage BT, further investigation is recommended.

KeywordsSalvage brachytherapy Prostate cancer High-dose-rate-brachytherapy Low-dose-rate-brachytherapy Androgen deprivation therapy AbbreviationsBTBrachytherapy

ptsPatients

HDR-BTHigh-dose-rate brachytherapy

LDR-BTLow-dose-rate brachytherapy

BED2 GyBiological equivalent doses

ADTAndrogen deprivation therapy

FFbFFreedom from biochemical failure

OSOverall survival

GUGenitourinary

GIGastrointestinal

CTCv3.0Common Terminology Criteria for Adverse Events

α-βalpha-beta

CTVClinical target volume

DFSDisease-free survival

DMFSDistant metastasis free survival

CSSCause-specific survival

PSAProstate antigen specific

GyGray

EBRTExternal beam radiotherapy.

Electronic supplementary materialThe online version of this article doi:10.1186-1748-717X-9-102 contains supplementary material, which is available to authorized users.

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Autor: Iván Henríquez - Gemma Sancho - Asunción Hervás - Benjamin Guix - Joan Pera - Cristina Gutierrez - Oscar Abuchaibe - Ra

Fuente: https://link.springer.com/







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