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Prostate Cancer
Volume 2016, Article ID 9561494, 9 pages
http://dx.doi.org/10.1155/2016/9561494
Research Article

Salvage Brachytherapy for Biochemically Recurrent Prostate Cancer following Primary Brachytherapy

1Department of Urology, University of Kentucky College of Medicine, Lexington, KY 40536, USA
2Department of Radiation Oncology, University of Kentucky College of Medicine, Lexington, KY 40536, USA
3University of Kentucky College of Medicine, Lexington, KY 40536, USA
4Department of Biostatistics, University of Kentucky College of Public Health, Lexington, KY 40536, USA
5Comprehensive Cancer Centers of Nevada, Las Vegas, NV 89169, USA

Received 21 October 2015; Revised 22 January 2016; Accepted 22 February 2016

Academic Editor: Hendrik Van Poppel

Copyright © 2016 John M. Lacy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. In this study, we evaluated our experience with salvage brachytherapy after discovery of biochemical recurrence after a prior brachytherapy procedure. Methods and Materials. From 2001 through 2012 twenty-one patients treated by brachytherapy within University of Kentucky or from outside centers developed biochemical failure and had no evidence of metastases. Computed tomography (CT) scans were evaluated; patients who had an underseeded portion of their prostate were considered for reimplantation. Results. The majority of the patients in this study (61.9%) were low risk and median presalvage PSA was 3.49 (range 17.41–1.68). Mean follow-up was 61 months. At last follow-up after reseeding, 11/21 (52.4%) were free of biochemical recurrence. There was a trend towards decreased freedom from biochemical recurrence in low risk patients (). International Prostate Symptom Scores (IPSS) increased at 3-month follow-up visits but decreased and were equivalent to baseline scores at 18 months. Conclusions. Salvage brachytherapy after primary brachytherapy is possible; however, in our experience the side-effect profile after the second brachytherapy procedure was higher than after the first brachytherapy procedure. In this cohort of patients we demonstrate that approximately 50% oncologic control, low risk patients appear to have better outcomes than others.