@Article{Maenhout2017,
journal="Journal of Contemporary Brachytherapy",
issn="1689-832X",
volume="9",
number="2",
year="2017",
title="Second salvage high-dose-rate brachytherapy for radiorecurrent prostate cancer",
abstract=" Purpose : Salvage treatments for localized radiorecurrent prostate cancer can be performed safely when a focal and image guided approach is used. Due to the low toxicity, the opportunity exists to investigate a second salvage treatment when a second locally recurrent prostate cancer occurs. Here, we describe a second salvage treatment procedure of 4 patients.    Material and methods : Four patients with a pathologically proven second local recurrence were treated in an outpatient magnetic resonance imaging (MRI)-guided setting with a single fraction of 19 Gy focal high-dose-rate brachytherapy (HDR-BT). Delineation was performed using choline-PET-CT or a 68Ga-PSMA PET in combination with multiparametric 3 Tesla MRI in all four patients. Toxicity was measured using common toxicity criteria for adverse events (CTCAE) version 4.0.    Results : With a median follow-up of 12 months (range, 6-15), there were 2 patients with biochemical recurrence as defined by the Phoenix-definition. There were no patients with grade 3 or more toxicity. In all second salvage HDR-BT treatments, the constraints for rectum, bladder, and urethra were met. Median treatment volume (GTV) was 4.8 cc (range, 1.9-6.6 cc). A median of 8 catheters (range, 6-9) were used, and the median dose to the treatment volume (GTV) was a D95: 19.3 Gy (SD 15.5-19.4 Gy).    Conclusions : Second focal salvage MRI-guided HDR-BT for a select group of patients with a second locally recurrent prostate cancer is feasible. There was no grade 3 or more acute toxicity for these four patients.",
author="Maenhout, Metha
and Vulpen, Marco van
and Moerland, Marinus
and Peters, Max
and Meijer, Richard
and Bosch, Maurice van den
and Nguyen, Paul
and Frank, Steven
and Zyp, Jochem van der Voort van",
pages="161--166",
doi="10.5114/jcb.2017.67015",
url="http://dx.doi.org/10.5114/jcb.2017.67015"
}