Long-Term (10-15 Year) Results With High-Dose-Rate-(HDR) Salvage Therapy for Recurrent Prostate Cancer

PurposeThere are limited treatments available for recurrent prostate cancer patients. Modality selection can be challenging for both the patient and their doctors. HDR brachytherapy has been used extensively as a boost after external beam radiation therapy, but is increasingly being tested as salvage treated for locally recurrent prostate cancer. We report our long-term results for HDR salvage brachytherapy in patients with initially low, intermediate, and high risk prostate cancer.Methods and MaterialsPatients (n=28) with a median age of 71 (57-84) years at recurrence with low- (n=10), intermediate- (n=9), and high-risk prostate cancer (n=) treated at the California Endocurietherapy (CET now at UCLA) between 1991 and 2009 were analyzed. Median HDR brachytherapy dose prescription was 36 (15-46) Gy in 6 (1-8) fractions. Six patients did receive additional external beam radiation therapy (EBRT) after HDR brachytherapy to an EBRT dose of 36 (36-50) Gy. Presenting disease characteristics were median recurrent PSA 8.1 (1.4-86.7) ng/mL, Gleason Score 7 (5-10), median prostate volume 23.2 (0-80) cc. Androgen deprivation therapy was administered in 68% for a median of 6 (3-96) months. Risk groups were defined according to the NCCN guidelines. Sustained PSA nadir+2 was used to define biochemical relapse. Statistical analyses being performed are to include Kaplan-Meier analyses and univariate and multivariate Cox proportional analyses.ResultsPreliminary analysis shows that the median overall follow-up time was 6.90 (0.30-15.92) years. The 5, 10 and 15 year overall survival (OS) rates were 86%, 36% and 11%, respectively. The 5, 10 and 15 year distant metastases-free survival (DMFS) rates were 68%, 29% and 11%, respectively. Univariate Cox analyses and multivariate analyses are currently underway to determine the impact of PSA, T-stage, risk group, Gleason Score, age and androgen deprivation therapy on Biochemical progression free survival (BPFS).ConclusionsOur long-term data validates HDR salvage brachytherapy in recurrent prostate cancer patients as a standard treatment option which offers excellent rates of disease control. PurposeThere are limited treatments available for recurrent prostate cancer patients. Modality selection can be challenging for both the patient and their doctors. HDR brachytherapy has been used extensively as a boost after external beam radiation therapy, but is increasingly being tested as salvage treated for locally recurrent prostate cancer. We report our long-term results for HDR salvage brachytherapy in patients with initially low, intermediate, and high risk prostate cancer. There are limited treatments available for recurrent prostate cancer patients. Modality selection can be challenging for both the patient and their doctors. HDR brachytherapy has been used extensively as a boost after external beam radiation therapy, but is increasingly being tested as salvage treated for locally recurrent prostate cancer. We report our long-term results for HDR salvage brachytherapy in patients with initially low, intermediate, and high risk prostate cancer. Methods and MaterialsPatients (n=28) with a median age of 71 (57-84) years at recurrence with low- (n=10), intermediate- (n=9), and high-risk prostate cancer (n=) treated at the California Endocurietherapy (CET now at UCLA) between 1991 and 2009 were analyzed. Median HDR brachytherapy dose prescription was 36 (15-46) Gy in 6 (1-8) fractions. Six patients did receive additional external beam radiation therapy (EBRT) after HDR brachytherapy to an EBRT dose of 36 (36-50) Gy. Presenting disease characteristics were median recurrent PSA 8.1 (1.4-86.7) ng/mL, Gleason Score 7 (5-10), median prostate volume 23.2 (0-80) cc. Androgen deprivation therapy was administered in 68% for a median of 6 (3-96) months. Risk groups were defined according to the NCCN guidelines. Sustained PSA nadir+2 was used to define biochemical relapse. Statistical analyses being performed are to include Kaplan-Meier analyses and univariate and multivariate Cox proportional analyses. Patients (n=28) with a median age of 71 (57-84) years at recurrence with low- (n=10), intermediate- (n=9), and high-risk prostate cancer (n=) treated at the California Endocurietherapy (CET now at UCLA) between 1991 and 2009 were analyzed. Median HDR brachytherapy dose prescription was 36 (15-46) Gy in 6 (1-8) fractions. Six patients did receive additional external beam radiation therapy (EBRT) after HDR brachytherapy to an EBRT dose of 36 (36-50) Gy. Presenting disease characteristics were median recurrent PSA 8.1 (1.4-86.7) ng/mL, Gleason Score 7 (5-10), median prostate volume 23.2 (0-80) cc. Androgen deprivation therapy was administered in 68% for a median of 6 (3-96) months. Risk groups were defined according to the NCCN guidelines. Sustained PSA nadir+2 was used to define biochemical relapse. Statistical analyses being performed are to include Kaplan-Meier analyses and univariate and multivariate Cox proportional analyses. ResultsPreliminary analysis shows that the median overall follow-up time was 6.90 (0.30-15.92) years. The 5, 10 and 15 year overall survival (OS) rates were 86%, 36% and 11%, respectively. The 5, 10 and 15 year distant metastases-free survival (DMFS) rates were 68%, 29% and 11%, respectively. Univariate Cox analyses and multivariate analyses are currently underway to determine the impact of PSA, T-stage, risk group, Gleason Score, age and androgen deprivation therapy on Biochemical progression free survival (BPFS). Preliminary analysis shows that the median overall follow-up time was 6.90 (0.30-15.92) years. The 5, 10 and 15 year overall survival (OS) rates were 86%, 36% and 11%, respectively. The 5, 10 and 15 year distant metastases-free survival (DMFS) rates were 68%, 29% and 11%, respectively. Univariate Cox analyses and multivariate analyses are currently underway to determine the impact of PSA, T-stage, risk group, Gleason Score, age and androgen deprivation therapy on Biochemical progression free survival (BPFS). ConclusionsOur long-term data validates HDR salvage brachytherapy in recurrent prostate cancer patients as a standard treatment option which offers excellent rates of disease control. Our long-term data validates HDR salvage brachytherapy in recurrent prostate cancer patients as a standard treatment option which offers excellent rates of disease control.