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Focal MRI-Guided Salvage High-Dose-Rate Brachytherapy in Patients With Radiorecurrent Prostate Cancer.

Abstract Whole-gland salvage treatment of radiorecurrent prostate cancer has a high rate of severe toxicity. The standard of care in case of a biochemical recurrence is androgen deprivation treatment, which is associated with morbidity and negative effects on quality of life. A salvage treatment with acceptable toxicity might postpone the start of androgen deprivation treatment, might have a positive influence on the patients' quality of life, and might even be curative. Here, toxicity and biochemical outcome are described after magnetic resonance imaging-guided focal salvage high-dose-rate brachytherapy in patients with radiorecurrent prostate cancer.
PMID
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Authors

Mayor MeshTerms
Keywords

HDR brachytherapy

MRI guidance

focal treatment

recurrent prostate cancer

salvage treatment

Journal Title technology in cancer research & treatment
Publication Year Start




PMID- 29333958
OWN - NLM
STAT- In-Data-Review
LR  - 20180119
IS  - 1533-0338 (Electronic)
IS  - 1533-0338 (Linking)
VI  - 16
IP  - 6
DP  - 2017 Dec
TI  - Focal MRI-Guided Salvage High-Dose-Rate Brachytherapy in Patients With
      Radiorecurrent Prostate Cancer.
PG  - 1194-1201
LID - 10.1177/1533034617741797 [doi]
AB  - INTRODUCTION: Whole-gland salvage treatment of radiorecurrent prostate cancer has
      a high rate of severe toxicity. The standard of care in case of a biochemical
      recurrence is androgen deprivation treatment, which is associated with morbidity 
      and negative effects on quality of life. A salvage treatment with acceptable
      toxicity might postpone the start of androgen deprivation treatment, might have a
      positive influence on the patients' quality of life, and might even be curative. 
      Here, toxicity and biochemical outcome are described after magnetic resonance
      imaging-guided focal salvage high-dose-rate brachytherapy in patients with
      radiorecurrent prostate cancer. MATERIALS AND METHODS: Seventeen patients with
      pathologically proven locally recurrent prostate cancer were treated with focal
      high-dose-rate brachytherapy in a single 19-Gy fraction using magnetic resonance 
      imaging for treatment guidance. Primary radiotherapy consisted of external beam
      radiotherapy or low-dose-rate brachytherapy. Tumors were delineated with
      Ga-68-prostate-specific membrane antigen or F18-choline positron emission
      tomography in combination with multiparametric magnetic resonance imaging. All
      patients had a prostate-specific antigen level of less than 10 ng/mL at the time 
      of recurrence and a prostate-specific antigen doubling time of >/=12 months.
      Toxicity was measured by using the Common Terminology Criteria for Adverse Events
      version 4. RESULTS: Eight of 17 patients had follow-up interval of at least 1
      year. At a median follow-up interval of 10 months (range 3-40 months), 1 patient 
      experienced a biochemical recurrence according to the Phoenix criteria, and
      prostate-specific membrane antigen testing revealed that this was due to a
      distant nodal metastasis. One patient had a grade 3 urethral stricture at 2 years
      after treatment. CONCLUSION: Focal salvage high-dose-rate brachytherapy in
      patients with radiorecurrent prostate cancer showed grade 3 toxicity in 1 of 17
      patients and a distant nodal metastasis in another patient. Whether this
      treatment option leads to cure in a subset of patients or whether it can
      successfully postpone androgen deprivation treatment needs further investigation.
FAU - Maenhout, Metha
AU  - Maenhout M
AD  - 1 Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the
      Netherlands.
FAU - Peters, Max
AU  - Peters M
AD  - 1 Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the
      Netherlands.
FAU - van Vulpen, Marco
AU  - van Vulpen M
AD  - 2 Department of Urology, University Medical Center Utrecht, Utrecht, the
      Netherlands.
FAU - Moerland, Marinus A
AU  - Moerland MA
AD  - 1 Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the
      Netherlands.
FAU - Meijer, Richard P
AU  - Meijer RP
AD  - 1 Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the
      Netherlands.
FAU - van den Bosch, Maurice A A J
AU  - van den Bosch MAAJ
AD  - 1 Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the
      Netherlands.
FAU - Nguyen, Paul L
AU  - Nguyen PL
AD  - 3 Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA,
      USA.
FAU - Frank, Steven J
AU  - Frank SJ
AD  - 4 Department of Radiation Oncology, The University of Texas MD Anderson Cancer
      Center, Houston, TX, USA.
FAU - van der Voort van Zyp, Jochem R N
AU  - van der Voort van Zyp JRN
AD  - 1 Department of Radiotherapy, University Medical Center Utrecht, Utrecht, the
      Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20171205
PL  - United States
TA  - Technol Cancer Res Treat
JT  - Technology in cancer research & treatment
JID - 101140941
PMC - PMC5762090
OTO - NOTNLM
OT  - HDR brachytherapy
OT  - MRI guidance
OT  - focal treatment
OT  - recurrent prostate cancer
OT  - salvage treatment
EDAT- 2018/01/16 06:00
MHDA- 2018/01/16 06:00
CRDT- 2018/01/16 06:00
PHST- 2018/01/16 06:00 [entrez]
PHST- 2018/01/16 06:00 [pubmed]
PHST- 2018/01/16 06:00 [medline]
AID - 10.1177/1533034617741797 [doi]
PST - ppublish
SO  - Technol Cancer Res Treat. 2017 Dec;16(6):1194-1201. doi:
      10.1177/1533034617741797. Epub 2017 Dec 5.