Focal salvage high-dose-rate brachytherapy with implantable rectum spacer for locally recurrent prostate cancer after initial low-dose-rate with grade 3 rectal toxicity.

IF 1.1 4区 医学 Q4 ONCOLOGY Journal of Contemporary Brachytherapy Pub Date : 2023-04-01 DOI:10.5114/jcb.2023.126051
Thirza Opbroek, Anne Cobussen, Evert J Van Limbergen, Ben G L Vanneste
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Abstract

Purpose: Locally recurrent prostate cancer after previous radiation therapy remains challenging. One of the curative options for these patients is salvage brachytherapy. There are no reports available on the use of a biodegradable rectal balloon implantation (RBI) in combination with brachytherapy in patients with recurrent prostate cancer after previous radiotherapy.

Case presentation: Here, we report on a patient with a local recurrence at five years after previous low-dose-rate brachytherapy with a prescribed dose of 145 Gray (Gy) for a low-risk prostate adenocarcinoma. The patient experienced grade 3 rectal toxicity, which was resolved at the time of local recurrence. He was treated with focal high-dose-rate (HDR) brachytherapy of 2 fr. × 13 Gy after RBI implantation. Four years post-salvage treatment, there was no evidence of biochemical recurrence according Phoenix definition, and no gastro-intestinal or genitourinary toxicity.

Conclusions: This case describes the use of RBI implantation in combination with a focal salvage HDR in a patient with recurrent disease, with significant initial grade 3 rectal toxicity after previous irradiation. The use of a biodegradable RBI proved to be a promising solution for such a patient; however, this method needs to be further investigated.

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植入式直肠间隔器局部补救性高剂量率近距离治疗原发性低剂量直肠毒性3级前列腺癌复发。
目的:既往放射治疗后局部复发的前列腺癌仍然具有挑战性。这些患者的治疗选择之一是抢救性近距离放射治疗。目前还没有关于生物可降解直肠球囊植入(RBI)联合近距离放疗治疗前列腺癌复发患者的报道。病例介绍:在这里,我们报告了一个低风险前列腺癌患者,在先前低剂量率近距离放射治疗145 Gy后5年局部复发。患者经历了3级直肠毒性,在局部复发时得到了解决。RBI植入后给予局灶性高剂量率(HDR)近距离治疗2 × 13 Gy。抢救治疗4年后,无凤凰定义生化复发,无胃肠道及泌尿生殖系统毒性。结论:本病例描述了在复发性疾病患者中使用RBI植入联合局灶补救性HDR,先前照射后具有明显的初始3级直肠毒性。使用可生物降解的RBI被证明是一种很有前途的解决方案。然而,这种方法还需要进一步的研究。
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来源期刊
Journal of Contemporary Brachytherapy
Journal of Contemporary Brachytherapy ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
2.40
自引率
14.30%
发文量
54
审稿时长
16 weeks
期刊介绍: The “Journal of Contemporary Brachytherapy” is an international and multidisciplinary journal that will publish papers of original research as well as reviews of articles. Main subjects of the journal include: clinical brachytherapy, combined modality treatment, advances in radiobiology, hyperthermia and tumour biology, as well as physical aspects relevant to brachytherapy, particularly in the field of imaging, dosimetry and radiation therapy planning. Original contributions will include experimental studies of combined modality treatment, tumor sensitization and normal tissue protection, molecular radiation biology, and clinical investigations of cancer treatment in brachytherapy. Another field of interest will be the educational part of the journal.
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