Salvage low-dose-rate permanent seed brachytherapy for locally recurrent XXXX : Association between dose and late @entity137 .

@entity1 @entity137 @entity263 @entity344
PURPOSE: Rates of late @entity137 are higher for salvage treatment of local recurrence after prior radiotherapy. We present our experience with salvage prostate brachytherapy (BT) for local recurrence after definitive external beam radiotherapy with attention to the relationship between dose and late @entity137 . METHODS AND MATERIALS: From 2005 to 2012, 18 @entity1 with biopsy proven locally recurrent @entity263 and negative staging received low-dose-rate BT with a prescribed dose of 130-144  Gy. @entity137 were graded using Common Terminology Criteria for Adverse Events, version 3.0. RESULTS: Median followup is 31.5  months (range, 12-104). International Prostate Symptom Scores peaked at 3  months (median, 21/35), returning to baseline by 24  months. Urinary catheterization rate was 33% (median duration, 14  days; range, 1-90  days). Late Grade 3/4 genitourinary @entity137 occurred in 1 @entity1 each, one of whom also had Grade 3 late @entity344 ; urethral strictures developed in three others. These 5 @entity1 with late @entity137 had higher dose to the prostate (isodose enclosing 90% [D90] median, 151 Gy; range, 135-185 Gy) compared with those without late complications (median, 134  Gy; range, 105-165; p < 0.04). Acute @entity344 Grade <3 occurred in 44%. Four @entity1 (22%) experienced biochemical failure. CONCLUSION: Salvage low-dose-rate prostate BT can provide durable biochemical control. Care should be taken to select @entity1 with higher likelihood of organ-confined disease. The goal of planning should be to treat the recurrent disease to an adequate dose with careful attention to maintain a conservative D90.
