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Soror T, Paul J, Melchert C, Idel C, Rades D, Bruchhage KL, Kovács G, Leichtle A. Salvage High-Dose-Rate Interventional Radiotherapy (Brachytherapy) Combined with Surgery for Regionally Relapsed Head and Neck Cancers. Cancers (Basel) 2023; 15:4549. [PMID: 37760518 PMCID: PMC10526533 DOI: 10.3390/cancers15184549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/11/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: to report on the use of high-dose-rate (HDR) interventional radiotherapy (brachytherapy, IRT) as a salvage treatment for patients with regionally relapsed head and neck cancers. (2) Methods: A retrospective study of 60 patients treated with HDR-IRT for loco-regionally relapsed head and neck cancers at our institution (2016-2020). Treatment procedure, results, and related toxicities were collected. Local and overall survival outcomes were analyzed. (3) Results: The median follow-up was 22.4 months. Twenty-nine (48.3%) patients had locoregional recurrences with a median time of 28.9 months. The local-recurrence free-survival was 88.1% and 37.3% at 3 years and 5 years. At the last follow-up, 21 patients were alive and the median time to death was 24 months. The overall survival was 39.2% and 16.6% at 3 years and 5 years. Collectively, there were 28 events of grade ≥ 3 late toxicities recorded in 21 patients (35%). (4) Conclusions: Salvage HDR-IRT combined with surgery offers a second-line curative treatment option for regionally relapsed head and neck cancers with acceptable outcomes and toxicities.
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Affiliation(s)
- Tamer Soror
- Radiation Oncology Department, University of Lübeck/UKSH-CL, 23562 Lübeck, Germany; (C.M.); (D.R.)
- National Cancer Institute (NCI), Radiation Oncology Department, Cairo University, Giza 12613, Egypt
| | - Justina Paul
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University of Lübeck, 23562 Lübeck, Germany; (J.P.); (C.I.); (K.-L.B.); (A.L.)
| | - Corinna Melchert
- Radiation Oncology Department, University of Lübeck/UKSH-CL, 23562 Lübeck, Germany; (C.M.); (D.R.)
| | - Christian Idel
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University of Lübeck, 23562 Lübeck, Germany; (J.P.); (C.I.); (K.-L.B.); (A.L.)
| | - Dirk Rades
- Radiation Oncology Department, University of Lübeck/UKSH-CL, 23562 Lübeck, Germany; (C.M.); (D.R.)
| | - Karl-Ludwig Bruchhage
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University of Lübeck, 23562 Lübeck, Germany; (J.P.); (C.I.); (K.-L.B.); (A.L.)
| | - György Kovács
- Università Cattolica del Sacro Cuore, Gemelli-INTERACTS, 00168 Rome, Italy;
| | - Anke Leichtle
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University of Lübeck, 23562 Lübeck, Germany; (J.P.); (C.I.); (K.-L.B.); (A.L.)
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Salvage Perioperative Interstitial High-Dose-Rate Interventional Radiotherapy (Brachytherapy) for Local Recurrences of the Chest Wall Following Mastectomy and Previous External Irradiation. Cancers (Basel) 2023; 15:cancers15030614. [PMID: 36765571 PMCID: PMC9913130 DOI: 10.3390/cancers15030614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 01/20/2023] Open
Abstract
(1) Background: To investigate the technical feasibility, safety, and efficacy of interstitial perioperative high-dose-rate interventional radiotherapy (HDR-IRT, brachytherapy) as a local salvage treatment combined with surgery for local chest wall recurrences following mastectomy and subsequent external beam radiation treatment (EBRT). (2) Methods: A retrospective analysis of 56 patients treated with interstitial HDR-IRT in combination with local surgery of a chest wall recurrence of breast cancer after previous treatment with mastectomy and EBRT from 2008 to 2020. (3) Results: Local recurrence following HDR-IRT was encountered in seven (12.5%) patients. The 1-year local recurrence-free survival (RFS), 3-year RFS, and 5-year RFS were 91%, 82%, and 82%, respectively. The 1-year overall survival (OS), 3-year OS, and 5-year OS was 85.5%, 58%, and 30%, respectively. Acute grade 1-2 radiation dermatitis was observed in 22 (39.3%) patients. Late ≥grade 3 toxicities were encountered in five (8.9%) patients. (4) Conclusions: Salvage perioperative interstitial high-dose-rate interventional radiotherapy (brachytherapy) combined with surgery seems to be an effective interdisciplinary management with acceptable treatment-related toxicity for local recurrences of the chest wall following mastectomy and previous external irradiation.
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Yamazaki H, Masui K, Suzuki G, Yoshida K, Nakamura S, Isohashi F, Kotsuma T, Takaoka Y, Tanaka E, Akiyama H, Ishibashi N. Reirradiation for recurrent head and neck carcinoma using high-dose-rate brachytherapy: A multi-institutional study. Brachytherapy 2022; 21:341-346. [DOI: 10.1016/j.brachy.2021.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/15/2021] [Accepted: 12/28/2021] [Indexed: 11/02/2022]
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Outcomes and toxicities of re-irradiation for prostate cancer: A systematic review on behalf of the Re-Irradiation Working Group of the Italian Association of Radiotherapy and Clinical Oncology (AIRO). Cancer Treat Rev 2021; 95:102176. [PMID: 33743409 DOI: 10.1016/j.ctrv.2021.102176] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 11/24/2022]
Abstract
AIMS The best therapeutic approach for local relapses of previously irradiated prostate cancer (PC) is still not defined. Re-irradiation (Re-I) could offer a chance of cure for highly selected patients, although high quality evidences are lacking. The aim of our study is to provide a literature review on efficacy and safety of Re-I. METHODS Only studies where Re-I field overlaps with previous radiotherapy were considered. To determine 2 and 4 years overall mortality (OM), 2 and 4 years biochemical failure (BF) and pooled acute and late G ≥ 3 toxicities rate, a meta-analysis over single arm study was performed. RESULTS Thirty-eight studies with 1194 patients were included. Median follow-up from Re-I was 30 months (10-94 months). Brachytherapy (BRT) was the most used Re-I technique (27 studies), followed by Stereotactic Body Radiotherapy (SBRT) (9) and External Beam Radiation Therapy (EBRT) (2). Re-I prescription doses ranged from 19 Gy in single HDR fraction to 145 Gy (interstitial BRT). The pooled 2 and 4 years OM rates were 2.1% (95%CI:1.1-3.7%, P < 0.001) and 12.5% (95%CI:8.1-19.5%; P < 0.001). The pooled 2 years BF rate was 24% (95% CI: 19.1-30.2%, P < 0.001). The pooled 4 years BF was 35.6% (95% CI: 28.7-44.3%, P < 0.001). The pooled result of G ≥ 3 acute toxicity was 1.4% (95%CI: 0.7-3%, P < 0.001). One hundred and three G ≥ 3 late adverse events were reported, with a pooled result of G ≥ 3 late toxicity of 8.7% (95%CI: 5.8-13%, P < 0.001). CONCLUSIONS Re-I of local failures from PC showed promising OM and biochemical control rates with a safe toxicity profile.
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A national surveillance study of the current status of reirradiation using brachytherapy in Japan. Brachytherapy 2020; 20:226-231. [PMID: 32888854 DOI: 10.1016/j.brachy.2020.07.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/28/2020] [Accepted: 07/04/2020] [Indexed: 12/29/2022]
Abstract
PURPOSE This study aimed to explore the current status and pattern of practice for reirradiation using brachytherapy (ReRT-BT) through a survey in Japan. MATERIALS AND METHODS We distributed an e-mail-based questionnaire to 153 institutions equipped with high-dose-rate brachytherapy facilities. RESULTS We received responses from 76 institutions (49.7%). Forty-three of these institutions performed ReRT-BT and 42 institutions (55%) performed ReRT-BT during 2009-2018. However, 29 of the 42 institutions (69%) reported difficulty in obtaining ReRT-BT case information from their respective databases. Almost all the institutions encountered insufficient database system to extract details about the ReRT-BT cases. Responses from 33 institutions included the number of ReRT-BT cases; this increased from 90 in the period 2009-2013 (institution median = 0.5; 0-16) to 172 in the period 2014-2018 (institution median = 2; 0-26). Nine institutions had to perform ReRT-BT for more than one case per year. The major location for cancer treatment was the pelvis (94%), followed by the head and neck (5%) and others (1%). In six site-specific scenarios, barring uterine corpus cancer recurrence, more than 90% of radiation oncologists agreed to perform ReRT-BT, whereas other areas (head and neck, prostate, and rectal cancer) gained 16-37% agreement. CONCLUSIONS This decade saw an increase in the number of ReRT-BT cases in Japan and radiation oncologists' interest in ReRT-BT as a viable therapeutic option. However, scarce availability, immature education system, and insufficient database system are barriers to further consensus building.
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Schönle N, Strnad V, Lotter M, Kreppner S, Fietkau R. Long-term results of a protocol-based ultrasound-guided salvage brachytherapy as re-irradiation for local recurrent prostate cancer. Radiother Oncol 2020; 150:201-205. [PMID: 32593646 DOI: 10.1016/j.radonc.2020.06.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND PURPOSE To assess the long-term results of protocol-based ultrasound-guided salvage pulsed-dose rate brachytherapy in locally recurrent prostate cancer following previous radiation therapy. MATERIALS AND METHODS A total of 82 patients (median age 69 years) with locally recurrent prostate cancer after previous external beam radiation therapy (43/82, 52.4%), prostatectomy and adjuvant radiation therapy (24/82, 29.3%) or brachytherapy (15/82, 18.3%) were treated with sole salvage interstitial pulsed-dose rate brachytherapy (PDR-BT). The treatment regimen consisted of two PDR-BT sections with 30 Gy (single pulse dose 0.6 Gy/h, 24 h per day) each up to a total reference dose of 60 Gy (EQD2 = 71.5 Gy-eq). The endpoints of the present analysis are cumulative local recurrence-rate, PSA-free survival, overall survival and the treatment-associated late toxicity according to the "Common Toxicity Criteria" with a median follow-up of 49 months (range, 12-129 months). RESULTS The 5-y. overall cumulative local recurrence rate was 17.7% with no significant differences between low, intermediate and high-risk groups. Differences in PSA-free survival were marginally non-significant, at 67.3%, 70.4% and 63.8% for low, intermediate and high risk group, respectively. No grade 3 gastrointestinal late side effects have been observed. The most common late side effect was urinary incontinence grade 1-3 and urinary frequency/urgency grade 1-3 in 18.3% (15/82) and 17.1% (14/82) of patients, respectively. CONCLUSION PDR salvage brachytherapy in local recurrent previously irradiated prostate cancer is efficient with low late toxicity. Salvage-brachytherapy represents a valuable therapeutic option for the treatment of previously irradiated locally recurrent prostate cancer.
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Vavassori A, Riva G, Cavallo I, Spoto R, Dicuonzo S, Fodor C, Comi S, Cambria R, Cattani F, Morra A, Leonardi MC, Lazzari R, Intra M, Luini A, Galimberti VE, Veronesi P, Orecchia R, Jereczek-Fossa BA. High-dose-rate Brachytherapy as Adjuvant Local rEirradiation for Salvage Treatment of Recurrent breAst cancer (BALESTRA): a retrospective mono-institutional study. J Contemp Brachytherapy 2020; 12:207-215. [PMID: 32695191 PMCID: PMC7366017 DOI: 10.5114/jcb.2020.96860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 04/13/2020] [Indexed: 01/06/2023] Open
Abstract
PURPOSE To evaluate clinical results of catheter-based interstitial high-dose-rate (HDR) brachytherapy (BT) as adjuvant treatment in previously irradiated recurrent breast cancer. MATERIAL AND METHODS Between January 2011 and September 2015, 31 consecutive patients with histologically confirmed recurrent breast cancer after conservative surgery and conventional whole breast radiotherapy, were retreated with a second conservative surgical resection and reirradiated with adjuvant interstitial HDR-BT. None of the brachytherapy implant was performed during the quadrantectomy procedure. A dose of 34 Gy in 10 fractions, 2 fractions per day, with a minimal interval of 6 hours was delivered. RESULTS At the time of the implant, the median age of patients was 59.7 years (range, 39.3-74.9 years). The median time from first treatment until BT for local recurrence was 11.9 years (range, 2.5-27.8 years). The median interval between salvage surgery and BT was 3.6 months (range, 1-8.2 months). No acute epidermitis or soft tissue side effects higher than grade 2 were recorded, with good cosmetic results in all patients. Most of the patients presented grade 1-2 late side effects. Only one patient developed grade 3 liponecrosis. After a median follow-up of 73.7 months (range, 28.8-102.4 months), the overall survival and cancer specific survival were 87.1% and 90.3%, respectively; 5-year local control and 5-year progression-free survival rate were 90.3% and 83.9%, respectively. CONCLUSIONS Our preliminary analysis showed that HDR-BT is a feasible treatment for partial breast reirradiation offering very low complications rate and fast procedure. Higher patients' cohort is warranted in order to define the role of this treatment modality in the breast conservative management of local recurrence.
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Affiliation(s)
- Andrea Vavassori
- Department of Radiotherapy, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Giulia Riva
- Department of Radiotherapy, IEO European Institute of Oncology IRCCS, Milan, Italy
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Iacopo Cavallo
- Department of Radiotherapy, IEO European Institute of Oncology IRCCS, Milan, Italy
- University of Milan, Department of Oncology and Hemato-Oncology, Milan, Italy
| | - Ruggero Spoto
- Department of Radiotherapy, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Samantha Dicuonzo
- Department of Radiotherapy, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Cristiana Fodor
- Department of Radiotherapy, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Stefania Comi
- Unit of Medical Physics, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Raffaella Cambria
- Unit of Medical Physics, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Federica Cattani
- Unit of Medical Physics, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Anna Morra
- Department of Radiotherapy, IEO European Institute of Oncology IRCCS, Milan, Italy
| | | | - Roberta Lazzari
- Department of Radiotherapy, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Mattia Intra
- Department of Breast Surgery, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Alberto Luini
- Department of Breast Surgery, IEO European Institute of Oncology IRCCS, Milan, Italy
| | | | - Paolo Veronesi
- Department of Breast Surgery, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Roberto Orecchia
- Scientific Directorate, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Barbara Alicja Jereczek-Fossa
- Department of Radiotherapy, IEO European Institute of Oncology IRCCS, Milan, Italy
- University of Milan, Department of Oncology and Hemato-Oncology, Milan, Italy
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Moningi S, Ludmir EB, Polamraju P, Williamson T, Melkun MM, Herman JD, Krishnan S, Koay EJ, Koong AC, Minsky BD, Smith GL, Taniguchi C, Das P, Holliday EB. Definitive hyperfractionated, accelerated proton reirradiation for patients with pelvic malignancies. Clin Transl Radiat Oncol 2019; 19:59-65. [PMID: 31517071 PMCID: PMC6734102 DOI: 10.1016/j.ctro.2019.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 08/23/2019] [Accepted: 08/26/2019] [Indexed: 12/25/2022] Open
Abstract
Introduction Pelvic reirradiation (re-RT) presents challenges due to concerns for late toxicity to tissues-at-risk including pelvic bone marrow (PBM). We routinely utilize a hyperfractionated, accelerated re-RT for recurrent rectal or anal cancer in the setting of prior radiation. We hypothesized that proton beam radiation (PBR) is uniquely suited to limit doses to pelvic non-target tissues better than photon-based approaches. Materials and methods All patients who received hyperfractionated, accelerated PBR re-RT to the pelvis from 2007 to 2017 were identified. Re-RT was delivered twice daily with a 6 h minimum interfraction interval at 1.5 Gray Relative Biological Effectiveness (Gy(RBE)) per fraction to a total dose of 39-45 Gy(RBE). Concurrent chemotherapy was given to all patients. Comparison photon plans were generated for dosimetric analysis. Dosimetric parameters compared using a matched-pair analysis and the Wilcoxon signed-rank test. Survival analysis was performed Kaplan Meier curves. Results Fifteen patients were identified, with a median prior pelvic RT dose of 50.4 Gy (range 25-80 Gy). Median time between the initial RT and PBRT re-RT was 4.7 years (range 1.0-36.1 years). In comparison to corresponding photon re-RT plans, PBR re-RT plans had lower mean PBM dose, and lower volume of PBM getting 5 Gy, 10 Gy, 20 Gy, and 30 Gy (p < 0.001, p < 0.001, p < 0.001, and p = 0.033, respectively).With median 13.9 months follow-up after PBR re-RT, five patients had developed local recurrences, and four patients had developed distant metastases. One-year overall survival following PBR re-RT was 67.5% and one-year progression free survival was 58.7%. No patients developed acute or late Grade 4 toxicity. Conclusion PBR re-RT affords improved sparing of PBM compared with photon-based re-RT. Clinically, PBR re-RT is well-tolerated. However, given modest control rates with definitive re-RT without subsequent surgical resection, a multidisciplinary approach should be favored in this setting when feasible.
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Affiliation(s)
- Shalini Moningi
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Ethan B Ludmir
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Praveen Polamraju
- School of Medicine, University of Texas Medical Branch, Galveston, TX, United States
| | - Tyler Williamson
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Marcella M Melkun
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Joseph D Herman
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Sunil Krishnan
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Eugene J Koay
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Albert C Koong
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Bruce D Minsky
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Grace L Smith
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Cullen Taniguchi
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Prajnan Das
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Emma B Holliday
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Baty M, Créhange G, Pasquier D, Palard X, Deleuze A, Gnep K, Key S, Beuzit L, Castelli J, de Crevoisier R. Salvage reirradiation for local prostate cancer recurrence after radiation therapy. For who? When? How? Cancer Radiother 2019; 23:541-558. [PMID: 31421999 DOI: 10.1016/j.canrad.2019.07.125] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 07/03/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE Literature review reporting results of salvage brachytherapy and stereotactic body radiotherapy for prostate recurrence only after radiotherapy for prostate cancer. MATERIALS AND METHODS A total of 38 studies (including at least 15 patients per study) were analysed: 19 using low-dose-rate brachytherapy, nine high-dose-rate brachytherapy and ten stereotactic body radiotherapy. Only five studies were prospective. The median numbers of patients were 30 for low-dose-rate brachytherapy, 34 for high-dose-rate brachytherapy, and 30 for stereotactic body radiotherapy. The median follow-up were 47months for low-dose-rate brachytherapy, 36months for high-dose-rate brachytherapy and 21months for stereotactic body radiotherapy. RESULTS Late genitourinary toxicity rates ranged, for grade 2: from 4 to 42% for low-dose-rate brachytherapy, from 7 to 54% for high-dose-rate brachytherapy and from 3 to 20% for stereotactic body radiotherapy, and for grade 3 or above: from 0 to 24% for low-dose-rate brachytherapy, from 0 to 13% for high-dose-rate brachytherapy and from 0 to 3% for grade 3 or above (except 12% in one study) for stereotactic body radiotherapy. Late gastrointestinal toxicity rates ranged, for grade 2: from 0 to 6% for low-dose-rate brachytherapy, from 0 to 14% for high-dose-rate brachytherapy and from 0 to 11% for stereotactic body radiotherapy, and for grade 3 or above: from 0 to 6% for low-dose-rate brachytherapy, and from 0 to 1% for high-dose-rate brachytherapy and stereotactic body radiotherapy. The 5-year biochemical disease-free survival rates ranged from 20 to 77% for low-dose-rate brachytherapy and from 51 to 68% for high-dose-rate brachytherapy. The 2- and 3-year disease-free survival rates ranged from 40 to 82% for stereotactic body radiotherapy. Prognostic factors of biochemical recurrence have been identified. CONCLUSION Despite a lack of prospective data, salvage reirradiation for prostate cancer recurrence can be proposed to highly selected patients and tumours. Prospective comparative studies are needed.
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Affiliation(s)
- M Baty
- Department of radiotherapy, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France
| | - G Créhange
- Department of radiotherapy, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
| | - D Pasquier
- Department of radiation oncology, centre Oscar-Lambret, 3, avenue Frédéric-Combemale, 59020 Lille, France
| | - X Palard
- Department of nuclear medicine, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France
| | - A Deleuze
- Department of oncology, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France
| | - K Gnep
- Department of radiotherapy, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France
| | - S Key
- Department of radiotherapy, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France
| | - L Beuzit
- Department of radiology, CHU de Rennes, 35000 Rennes, France
| | - J Castelli
- Department of radiotherapy, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France; LTSI, Inserm U1099, 35042 Rennes, France; Université Rennes 1, 35042 Rennes, France
| | - R de Crevoisier
- Department of radiotherapy, centre Eugène-Marquis, 3, avenue de la Bataille-Flandres-Dunkerque, 35000 Rennes, France; LTSI, Inserm U1099, 35042 Rennes, France; Université Rennes 1, 35042 Rennes, France.
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