High-Dose-Rate brachytherapy for salvage treatment of prostate cancer recurrence post-prostatectomy and radiotherapy: A multicenter retrospective analysis (HDR-REPOPRA) by UroGEC

IF 5.3 1区医学 Q1 ONCOLOGY

Radiotherapy and Oncology Pub Date : 2025-09-13 DOI:10.1016/j.radonc.2025.111145

Adam Kluska , Artur J. Chyrek , Benjamin Guix , Patricia Willisch , Tamer Soror , Mateusz Bilski , Ivan Garcia , Teresa Guix , Beatriz Vázquez , Wojciech Burchardt , Piotr Lelek , Ricarda Merten , Vratislav Strnad , Iosif Strouthos , Mario Terlizzi , David Büchser , Pierre Blanchard , Alfonso Gomez- Iturriaga , Piotr Wojcieszek

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引用次数: 0

Abstract

Background

Local recurrence of prostate cancer following radical prostatectomy (RP) and adjuvant or salvage external beam radiotherapy (a/sEBRT) presents a therapeutic challenge. Salvage high-dose-rate brachytherapy (HDR-BT) is a promising modality, though evidence remains limited.

Materials and Methods

We retrospectively analyzed 90 patients treated with salvage HDR-BT after RP and a/sEBRT across 10 UroGEC-ESTRO-affiliated European centers. Eligible patients had biopsy- or imaging-confirmed local recurrence and ECOG performance status 0–2. Primary endpoints were local recurrence-free survival (LRFS) and toxicity; secondary endpoints included biochemical failure-free survival (BFFS), metastasis-free survival (MFS), progression-free survival (PFS), and overall survival (OS).

Results

The median follow-up was 47 months. The 5-year LRFS was 81.1 %, BFFS 62 %, MFS 77.5 %, PFS 58.0 %, and OS 95.9 %. Biopsy-confirmed recurrence and use of androgen deprivation therapy (ADT) were associated with improved LRFS and PFS. Grade ≥3 genitourinary toxicity occurred in 5.5 % (acute) and 8.9 % (late) of patients; gastrointestinal grade 3 toxicity was observed in 1.1 %.

Conclusion

HDR-BT is a safe and effective salvage option for well-selected patients with local recurrence after RP and a/sEBRT. Our data support its feasibility, acceptable toxicity, and favorable oncologic outcomes. Biopsy confirmation and ADT use may improve results and should be considered in treatment planning. These findings warrant further prospective evaluation to optimize patient selection and refine salvage strategies.

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高剂量率近距离放疗对前列腺癌切除术和放疗后复发的挽救性治疗：UroGEC的多中心回顾性分析（HDR-REPOPRA）。

背景：前列腺癌根治性前列腺切除术（RP）和辅助或补救性外束放疗（a/sEBRT）后局部复发是一个治疗挑战。抢救性高剂量率近距离治疗（HDR-BT）是一种很有前途的治疗方式，尽管证据仍然有限。材料和方法：我们回顾性分析了10个urogec - estro附属欧洲中心的90例RP和a/sEBRT后接受补救性HDR-BT治疗的患者。符合条件的患者有活检或影像学证实的局部复发和ECOG表现状态0-2。主要终点是局部无复发生存期（LRFS）和毒性；次要终点包括生化无失败生存期（BFFS）、无转移生存期（MFS）、无进展生存期（PFS）和总生存期（OS）。结果：中位随访时间为47 个月。5年LRFS为81.1 %，BFFS为62 %，MFS为77.5 %，PFS为58.0 %，OS为95.9% %。活检证实的复发和雄激素剥夺治疗（ADT）的使用与LRFS和PFS的改善相关。分级 ≥ 3级发生泌尿生殖系统毒性的患者分别为5.5% %（急性）和8.9 %（晚期）；胃肠道3级毒性为1.1 %。结论：HDR-BT是RP和a/sEBRT术后局部复发患者的一种安全有效的挽救选择。我们的数据支持其可行性、可接受的毒性和有利的肿瘤预后。活检确认和ADT的使用可改善结果，应在治疗计划中予以考虑。这些发现为进一步的前瞻性评估提供了依据，以优化患者选择和完善挽救策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Radiotherapy and Oncology 医学-核医学

CiteScore

10.30

自引率

10.50%

发文量

2445

审稿时长

45 days

期刊介绍： Radiotherapy and Oncology publishes papers describing original research as well as review articles. It covers areas of interest relating to radiation oncology. This includes: clinical radiotherapy, combined modality treatment, translational studies, epidemiological outcomes, imaging, dosimetry, and radiation therapy planning, experimental work in radiobiology, chemobiology, hyperthermia and tumour biology, as well as data science in radiation oncology and physics aspects relevant to oncology.Papers on more general aspects of interest to the radiation oncologist including chemotherapy, surgery and immunology are also published.