Session Item

To assess effectiveness of HDR brachytherapy in a series of local relapse prostate cancer patients, through 5-years free-relapse survival and 5-years specific-cause overall survival rates.

Our series included patients with histopathological confirmation of local relapse prostate cancer. All patients also had an MRI or PET image that confirmed local recurrence only.

All patients received HDR brachytherapy in two implants, 15 days apart. Each implant consisted of 2 fractions of 8 Gy BID, for 32 Gy total dose. Procedure was performed with real-time ultrasound image guidance (Oncentra Prostate treatment).

Clinical variables (diagnosis risk group, primary treatment, biochemical failure PSA levels, MRI/PET-CT and histological findings, actual clinical status) was collected. Data was analyzed using SPSS´s multivariate analysis, and Kaplan-Meier to estimate survival rates.

From 34 patients studied, 27 (81.4%) were categorized at first diagnosis as Gleason 6, four as Gleason 7 (11.7%), one as Gleason 8 (2,9%), and one as Gleason 9 (2,9%).The time between diagnosis and recurrence had a median of 66.5 months (range 16-221 months).

The median PSA at the time of biochemical failure was 4.16 ng / ml (range 1.9-31.6 ng/ml).

Among those 34 patients confirmed as local relapse prostate cancer after external radiotherapy or LDR brachytherapy, and treated with HDR brachytherapy, there have been six events of local recurrence after salvage. 4 patients are alive with disease (in active treatment), and 2 have died with disease.

Follow-up of the series has a median follow-up of 48 months, with a range of 4 to 119 months.

Our series showed 67,8% 5 years biochemical failure free survival rate, and 94,1% 5 years specific cause overall survival.

In our study, there was significative and relevant free-relapse survival and specific-cause overall survival rates in local relapse prostate cancer patients treated with HDR brachytherapy. Free-relapse survival and specific-cause overall survival rates from our series are similar to those observed in different trials and shown by meta-analysis.