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
{"title":"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)。","authors":"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","doi":"10.1016/j.radonc.2025.111145","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Materials and Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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 %.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":21041,"journal":{"name":"Radiotherapy and Oncology","volume":"212 ","pages":"Article 111145"},"PeriodicalIF":5.3000,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"High-Dose-Rate brachytherapy for salvage treatment of prostate cancer recurrence post-prostatectomy and radiotherapy: A multicenter retrospective analysis (HDR-REPOPRA) by UroGEC\",\"authors\":\"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\",\"doi\":\"10.1016/j.radonc.2025.111145\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>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.</div></div><div><h3>Materials and Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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 %.</div></div><div><h3>Conclusion</h3><div>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.</div></div>\",\"PeriodicalId\":21041,\"journal\":{\"name\":\"Radiotherapy and Oncology\",\"volume\":\"212 \",\"pages\":\"Article 111145\"},\"PeriodicalIF\":5.3000,\"publicationDate\":\"2025-09-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiotherapy and Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0167814025046493\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiotherapy and Oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0167814025046493","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
High-Dose-Rate brachytherapy for salvage treatment of prostate cancer recurrence post-prostatectomy and radiotherapy: A multicenter retrospective analysis (HDR-REPOPRA) by UroGEC
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.
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.