Salvage high-dose brachytherapy in patients with local recurrence of prostate cancer after various types of primary treatment
- Authors: Solodkiy V.A.1, Pavlov A.Y.1, Dzidzaria A.G.1, Tsibulskii A.D.1, Fedotova A.D.1, Gubanova V.I.1
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Affiliations:
- FGBI «Russian Scientific Center for Radiology» of the Ministry of Healthcare of the Russian Federation
- Issue: No 1 (2025)
- Pages: 22-28
- Section: Original Articles
- URL: https://journals.eco-vector.com/1728-2985/article/view/687276
- DOI: https://doi.org/10.18565/urology.2025.1.22-28
- ID: 687276
Cite item
Abstract
Background. Prostate cancer (PCa) is the second most common cancer worldwide. Current methods of definitive treatment of PCa provide good recurrence-free survival in patients with low and intermediate risk of progression, and yet about a third of men will face the local recurrence in the next 10 years of life. Today, there is a great need to find optimal technologies for treating local relapses of PCa.
Aim. To analyze the efficiency and toxicity of salvage high dose-rate (HDR) brachytherapy in the treatment of local recurrences of prostate cancer after various types of primary treatment.
Materials and methods. A total of 98 patients with local relapse of PCa after various types of radical treatment were included in the study. The age of the patients was on average 68 years (minimum 53 years, maximum 84 years) [95% CI = 66.9-69.7 years]. Recruitment of patients was carried out from January 2015 to December 2022 at the Federal State Budgetary Institution Russian Scientific Center for Radiology of the Ministry of Health of Russia. After a comprehensive examination, all patients underwent salvage HDR brachytherapy. The study included 34 patients after radical prostatectomy and 64 patients after radiation treatments (EBRT, brachytherapy).
Results. The median follow-up was 36 months (3–84 months). Depending on the previous treatment, the patients were divided into 2 groups. Group I (n=34) included patients after radical prostatectomy, while in group II (n=64) there were men after radiation treatment (EBRT, brachytherapy). The 5-year PSA-progression-free survival in group I was significantly higher than in group II and was 88.2 and 67.2%, respectively (p=0.023). The incidence of late genitourinary toxicity of grades 1, 2, 3 in both groups was 22.4, 10.2, and 4.1%, respectively, and late gastrointestinal toxicity of grades 1 and 2 were 10.2 and 1%, respectively. Severe complications of grades 2 and 3, both from the urinary system and from the rectum, were observed only in group II.
Conclusion. HDR brachytherapy is an effective salvage treatment option for local relapses of PCa after previous radiation and surgical treatment.
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About the authors
Vladimir A. Solodkiy
FGBI «Russian Scientific Center for Radiology» of the Ministry of Healthcare of the Russian Federation
Email: mailbox@rncrr.rssi.ru
ORCID iD: 0000-0002-1641-6452
SPIN-code: 9556-6556
Ph.D., MD, professor, Academician of RAS, Director
Russian Federation, MoscowAndrey Yu. Pavlov
FGBI «Russian Scientific Center for Radiology» of the Ministry of Healthcare of the Russian Federation
Email: mailbox@rncrr.rssi.ru
ORCID iD: 0000-0002-2905-7735
SPIN-code: 8380-3919
Ph.D., MD, professor, Chief Director
Russian Federation, MoscowAlexander G. Dzidzaria
FGBI «Russian Scientific Center for Radiology» of the Ministry of Healthcare of the Russian Federation
Email: dzidzariamd@gmail.com
ORCID iD: 0000-0001-5789-375X
SPIN-code: 6383-0771
Ph.D., MD, Head of the Department of Oncourology
Russian Federation, MoscowAlexey D. Tsibulskii
FGBI «Russian Scientific Center for Radiology» of the Ministry of Healthcare of the Russian Federation
Author for correspondence.
Email: vracheg@mail.ru
ORCID iD: 0000-0002-1647-6180
SPIN-code: 1559-1728
Ph.D., MD, leading researcher at the Department of Oncourology
Russian Federation, MoscowAnna D. Fedotova
FGBI «Russian Scientific Center for Radiology» of the Ministry of Healthcare of the Russian Federation
Email: anny2512@yandex.ru
ORCID iD: 0009-0005-3404-9552
radiotherapist, junior researcher at the Department of Oncourology
Russian Federation, MoscowVarvara I. Gubanova
FGBI «Russian Scientific Center for Radiology» of the Ministry of Healthcare of the Russian Federation
Email: vracheg@mail.ru
ORCID iD: 0009-0002-0072-4773
1st year resident in oncology
Russian Federation, MoscowReferences
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