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Reirradiation of locally recurrent prostate cancer after primary radiotherapy

  • Review
  • Published:
Journal of Radiation Oncology

Abstract

Biochemical recurrence can occur after definitive treatment with external beam radiation therapy (EBRT) or brachytherapy (BRT) for localized prostate cancer. Prior to considering reirradiation for recurrent prostate cancer, appropriate patient selection is important in ensuring that patients are at a high likelihood for a local only recurrence. For appropriately selected patients, careful reirradiation using mostly brachytherapy techniques can provide durable long-term control with acceptable morbidity. Most of the published experience with reirradiation has been using low-dose rate (LDR) BRT, but early results using high-dose rate (HDR) BRT have also been promising. Generally, the use of EBRT as well as stereotactic body radiation therapy (SBRT) is still uncommon in a reirradiation setting, and further study will need to be performed to characterize its biochemical outcomes and toxicities. The radiation therapy oncology group (RTOG) 0526 is a recently closed phase II prospective trial that is investigating the role of reirradiation using LDR brachytherapy. Results from this study will help physicians better understand the long-term toxicities and biochemical outcomes of reirradiation using LDR BRT.

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References

  1. Siegel R, Naishadham D, Jemal A (2013) Cancer statistics, 2013. CA: Cancer J Clin 63(1):11–30

    Google Scholar 

  2. Agarwal PK, Sadetsky N, Konety BR, Resnick MI, Carroll PR (2008) Treatment failure after primary and salvage therapy for prostate cancer. Cancer 112(2):307–314

    Article  PubMed  Google Scholar 

  3. Moman MR, van den Berg CA, Boeken Kruger AE, Battermann JJ, Moerland MA, van der Heide UA, van Vulpen M (2010) Focal Salvage Guided by T<sub>2</sub>-Weighted and Dynamic Contrast-Enhanced Magnetic Resonance Imaging for Prostate Cancer Recurrences. Int J Radiat Oncol Biol Phys 76(3):741–746

    PubMed  Google Scholar 

  4. Kishi K, Sato M, Shirai S, Sonomura T, Yamama R (2012) Reirradiation of prostate cancer with rectum preservation: Eradicative high-dose-rate brachytherapy with natural type hyaluronate injection. Brachytherapy 11(2):144–148

    Article  PubMed  Google Scholar 

  5. Nguyen PL, Devlin PM, Beard CJ, Orio PF III, O'Leary MP, Wolfsberger LD, O'Farrell DA, Sweeney CM, Hadaschik BA, Hohenfellner M (2013) High-dose-rate brachytherapy for prostate cancer in a previously radiated patient with polyethylene glycol hydrogel spacing to reduce rectal dose: Case report and review of the literature. Brachytherapy 12(1):77–83

    Article  PubMed  Google Scholar 

  6. Nguyen PL, D'Amico AV, Lee AK, Warren Suh W (2007) Patient selection, cancer control, and complications after salvage local therapy for postradiation prostate‐specific antigen failure. Cancer 110(7):1417–1428

    Article  PubMed  Google Scholar 

  7. Jereczek-Fossa BA, Beltramo G, Fariselli L, Fodor C, Santoro L, Vavassori A, Zerini D, Gherardi F, Ascione C, Bossi-Zanetti I (2012) Robotic image-guided stereotactic radiotherapy, for isolated recurrent primary, lymph node or metastatic prostate cancer. Int J Radiat Oncol Biol Phys 82(2):889–897

    PubMed  Google Scholar 

  8. Grado GL, Collins JM, Kriegshauser JS, Balch CS, Grado MM, Swanson GP, Larson TR, Wilkes MM, Navickis RJ (1999) Salvage brachytherapy for localized prostate cancer after radiotherapy failure. Urology 53(1):2–10

    Article  CAS  PubMed  Google Scholar 

  9. Weber DC, Wang H, Cozzi L, Dipasquale G, Khan HG, Ratib O, Rouzaud M, Vees H, Zaidi H, Miralbell R (2009) RapidArc, intensity modulated photon and proton techniques for recurrent prostate cancer in previously irradiated patients: a treatment planning comparison study. Radiat Oncol 4:34

    PubMed Central  PubMed  Google Scholar 

  10. Aaronson DS, Yamasaki I, Gottschalk A, Speight J, Hsu I, Pickett B, Roach M, Shinohara K (2009) Salvage permanent perineal radioactive‐seed implantation for treating recurrence of localized prostate adenocarcinoma after external beam radiotherapy. BJU Int 104(5):600–604

    PubMed  Google Scholar 

  11. Allen GW, Howard AR, Jarrard DF, Ritter MA (2007) Management of prostate cancer recurrences after radiation therapy‐brachytherapy as a salvage option. Cancer 110(7):1405–1416

    Article  PubMed  Google Scholar 

  12. Alongi F, De Bari B, Campostrini F, Arcangeli S, Matei DV, Lopci E, Petralia G, Bellomi M, Chiti A, Magrini SM (2013) Salvage therapy of intraprostatic failure after radical external-beam radiotherapy for prostate cancer: A review. Crit Rev Oncol/Hematol 88(3):550–563

    Google Scholar 

  13. Gomez-Veiga F, Mariño A, Alvarez L, Rodriguez I, Fernandez C, Pertega S, Candal A (2012) Brachytherapy for the treatment of recurrent prostate cancer after radiotherapy or radical prostatectomy. BJU Int 109(s1):17–21

    PubMed  Google Scholar 

  14. Koutrouvelis P, Hendricks F, Lailas N, Gil-Montero G, Sehn J, Khawand N, Bondy H, Katz S (2003) Salvage reimplantation in patient with local recurrent prostate carcinoma after brachytherapy with three dimensional computed tomography-guided permanent pararectal implant. Technol Cancer Res Treatment 2(4):339–344

    Google Scholar 

  15. Lee HK, Adams MT, Motta J (2008) Salvage prostate brachytherapy for localized prostate cancer failure after external beam radiation therapy. Brachytherapy 7(1):17–21

    Article  PubMed  Google Scholar 

  16. Consensus statement: guidelines for PSA following radiation therapy. American Society for Therapeutic Radiology and Oncology Consensus Panel (1997). International journal of radiation oncology, biology, physics 37 (5):1035-1041

  17. Roach M 3rd, Hanks G, Thames H Jr, Schellhammer P, Shipley WU, Sokol GH, Sandler H (2006) Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys 65(4):965–974. doi:10.1016/j.ijrobp.2006.04.029

    PubMed  Google Scholar 

  18. Zagars GK, Pollack A, von Eschenbach AC (1995) Prostate cancer and radiation therapy—the message conveyed by serum prostate-specific antigen. Int J Radiat Oncol Biol Phys 33(1):23–35

    CAS  PubMed  Google Scholar 

  19. Ciezki JP, Reddy CA, Garcia J, Angermeier K, Ulchaker J, Mahadevan A, Chehade N, Altman A, Klein EA (2006) PSA kinetics after prostate brachytherapy: PSA bounce phenomenon and its implications for PSA doubling time. Int J Radiat Oncol Biol Phys 64(2):512–517

    CAS  PubMed  Google Scholar 

  20. Beyer DC (2003) Brachytherapy for recurrent prostate cancer after radiation therapy. In: Seminars in radiation oncology. vol 2. Elsevier, pp 158-165

  21. Ramey SJ, Marshall DT (2013) Re-irradiation for salvage of prostate cancer failures after primary radiotherapy. World J Urol 31(6):1339–1345

    PubMed  Google Scholar 

  22. Sartor CI, Strawderman MH, Lin X-H, Kish KE, McLaughlin PW, Sandler HM (1997) Rate of PSA rise predicts metastatic versus local recurrence after definitive radiotherapy. Int J Radiat Oncol Biol Phys 38(5):941–947

    CAS  PubMed  Google Scholar 

  23. RTOG Prostate Cancer Protocol. RTOG 0526. A prospective phase II trial of transperineal ultrasound-guided brachytherapy for locally recurrent prostate adenocarcinoma following external beam radiotherapy

  24. Stuurman-Wieringa RE, Sodha HS, de la Rosette JJ, de Reijke TM (2013) Salvage Treatment for Recurrent Prostate Cancer Following Brachytherapy: For Whom, When and Which? In: Interstitial Prostate Brachytherapy. Springer, Heidelberg, pp 215-238

  25. Crook J, Malone S, Perry G, Bahadur Y, Robertson S, Abdolell M (2000) Postradiotherapy prostate biopsies: what do they really mean? Results for 498 patients. Int J Radiat Oncol Biol Phys 48(2):355–367

    CAS  PubMed  Google Scholar 

  26. Chan TW, Kressel HY (1991) Prostate and seminal vesicles after irradiation: MR appearance. J Magn Reson Imaging 1(5):503–511

    CAS  PubMed  Google Scholar 

  27. Martino P, Scattoni V, Galosi AB, Consonni P, Trombetta C, Palazzo S, Maccagnano C, Liguori G, Valentino M, Battaglia M (2011) Role of imaging and biopsy to assess local recurrence after definitive treatment for prostate carcinoma (surgery, radiotherapy, cryotherapy, HIFU). World J Urol 29(5):595–605

    PubMed  Google Scholar 

  28. Pucar D, Sella T, Schoder H (2008) The role of imaging in the detection of prostate cancer local recurrence after radiation therapy and surgery. Curr Opin Urol 18(1):87–97. doi:10.1097/MOU.0b013e3282f13ac3

    PubMed  Google Scholar 

  29. Rouviere O, Valette O, Grivolat S, Colin-Pangaud C, Bouvier R, Chapelon JY, Gelet A, Lyonnet D (2004) Recurrent prostate cancer after external beam radiotherapy: value of contrast-enhanced dynamic MRI in localizing intraprostatic tumor–correlation with biopsy findings. Urology 63(5):922–927. doi:10.1016/j.urology.2003.12.017

    Article  PubMed  Google Scholar 

  30. Kahn D, Williams RD, Haseman MK, Reed NL, Miller SJ, Gerstbrein J (1998) Radioimmunoscintigraphy with In-111-labeled capromab pendetide predicts prostate cancer response to salvage radiotherapy after failed radical prostatectomy. J Clin Oncol 16(1):284–289

    CAS  PubMed  Google Scholar 

  31. Krause BJ, Souvatzoglou M (2011) Treiber U Imaging of prostate cancer with PET/CT and radioactively labeled choline derivates. In: Urologic Oncology: Seminars and Original Investigations. Elsevier

  32. Beyer DC (1999) Permanent brachytherapy as salvage treatment for recurrent prostate cancer. Urology 54(5):880–883

    Article  CAS  PubMed  Google Scholar 

  33. Moman MR, van der Poel HG, Battermann JJ, Moerland MA, van Vulpen M (2010) Treatment outcome and toxicity after salvage 125-I implantation for prostate cancer recurrences after primary 125-I implantation and external beam radiotherapy. Brachytherapy 9(2):119–125

    Article  PubMed  Google Scholar 

  34. Nguyen PL, Chen MH, D’Amico AV, Tempany CM, Steele GS, Albert M, Cormack RA, Carr-Locke DL, Bleday R, Suh WW (2007) Magnetic resonance image‐guided salvage brachytherapy after radiation in select men who initially presented with favorable‐risk prostate cancer. Cancer 110(7):1485–1492

    Article  PubMed  Google Scholar 

  35. Wallner KE, Nori D, Morse MJ, Sogani PC, Whitmore WF, Fuks Z (1990) 125iodine reimplantation for locally progressive prostatic carcinoma. J Urol 144(3):704–706

    CAS  PubMed  Google Scholar 

  36. Wong WW, Buskirk SJ, Schild SE, Prussak KA, Davis BJ (2006) Combined prostate brachytherapy and short-term androgen deprivation therapy as salvage therapy for locally recurrent prostate cancer after external beam irradiation. J Urol 176(5):2020–2024

    PubMed  Google Scholar 

  37. Chen CP, Weinberg V, Shinohara K, Roach M III, Nash M, Gottschalk A, Chang AJ, Hsu I (2013) Salvage HDR Brachytherapy for Recurrent Prostate Cancer After Previous Definitive Radiation Therapy: 5-Year Outcomes. Int J Radiat Oncol Biol Phys 86(2):324–329

    PubMed  Google Scholar 

  38. Jo Y, Fujii T, Hara R, Yokoyama T, Miyaji Y, Yoden E, Hiratsuka J, Nagai A (2012) Salvage high‐dose‐rate brachytherapy for local prostate cancer recurrence after radiotherapy–preliminary results. BJU Int 109(6):835–839

    PubMed  Google Scholar 

  39. Lee B, Shinohara K, Weinberg V, Gottschalk AR, Pouliot J, Roach M III, Hsu I (2007) Feasibility of high-dose-rate brachytherapy salvage for local prostate cancer recurrence after radiotherapy: The University of California–San Francisco experience. Int J Radiat Oncol Biol Phys 67(4):1106–1112

    PubMed  Google Scholar 

  40. Tharp M, Hardacre M, Bennett R, Jones WT, Stuhldreher D, Vaught J (2008) Prostate high-dose-rate brachytherapy as salvage treatment of local failure after previous external or permanent seed irradiation for prostate cancer. Brachytherapy 7(3):231–236

    Article  PubMed  Google Scholar 

  41. Henríquez I, Sancho G, Hervás A, Guix B, Pera J, Gutierrez C, Abuchaibe O, Martínez-Monge R, Tormo A, Polo A (2014) Salvage brachytherapy in prostate local recurrence after radiation therapy: predicting factors for control and toxicity. Radiat Oncol 9(1):102

    PubMed Central  PubMed  Google Scholar 

  42. Burri RJ, Stone NN, Unger P, Stock RG (2010) Long-term outcome and toxicity of salvage brachytherapy for local failure after initial radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys 77(5):1338–1344

    PubMed  Google Scholar 

  43. Wise AM, Stamey TA, McNeal JE, Clayton JL (2002) Morphologic and clinical significance of multifocal prostate cancers in radical prostatectomy specimens. Urology 60(2):264–269

    Article  PubMed  Google Scholar 

  44. Huang WC, Kuroiwa K, Serio AM, Bianco FJ Jr, Fine SW, Shayegan B, Scardino PT, Eastham JA (2007) The anatomical and pathological characteristics of irradiated prostate cancers may influence the oncological efficacy of salvage ablative therapies. J Urol 177(4):1324–1329

    PubMed  Google Scholar 

  45. da Silva JLF, Haddad CMK, Hanna SA, Abreu CEV (2008) Intensity Modulated Radiation Therapy as Salvage Option after Permanent Brachytherapy Failure in Prostate Cancer. Int J Radiat Oncol Biol Phys 72(1):S136

    Google Scholar 

  46. Vavassori A, Jereczek-Fossa BA, Beltramo G, De Cicco L, Fariselli L, Corinna Bianchi L, Possanzini M, Bergantin A, DeCobelli O, Orecchia R (2010) Image-guided robotic radiosurgery as salvage therapy for locally recurrent prostate cancer after external beam irradiation: retrospective feasibility study on six cases. Tumori 96(1):71

    PubMed  Google Scholar 

  47. Jereczek-Fossa BA, Orecchia R (2007) Evidence-based radiation oncology: definitive, adjuvant and salvage radiotherapy for non-metastatic prostate cancer. Radiother Oncol 84(2):197–215

    PubMed  Google Scholar 

  48. Pucar D, Hricak H, Shukla-Dave A, Kuroiwa K, Drobnjak M, Eastham J, Scardino PT, Zelefsky MJ (2007) Clinically significant prostate cancer local recurrence after radiation therapy occurs at the site of primary tumor: magnetic resonance imaging and step-section pathology evidence. Int J Radiat Oncol Biol Phys 69(1):62–69

    PubMed  Google Scholar 

  49. Wang H, Vees H, Miralbell R, Wissmeyer M, Steiner C, Ratib O, Senthamizhchelvan S, Zaidi H (2009) < sup>18</sup>F-fluorocholine PET-guided target volume delineation techniques for partial prostate re-irradiation in local recurrent prostate cancer. Radiother Oncol 93(2):220–225

    CAS  PubMed  Google Scholar 

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Acknowledgments

International Atomic Energy Agency (IAEA) has provided support for Gustavo Nader Marta fellowship program.

Conflict of interest

Mihir Naik DO declares that he has no conflict of interest.

Gustavo Nader Marta MD declares that he has no conflict of interest.

May Abdel-Wahab MD PhD declares that she has no conflict of interest.

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Authors and Affiliations

  1. Department of Radiation Oncology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Mihir Naik & May Abdel-Wahab

  2. Radiation Oncology Department-Hospital Sírio-Libanês and Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil

    Gustavo Nader Marta

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  1. Mihir Naik
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  2. Gustavo Nader Marta
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  3. May Abdel-Wahab
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Correspondence to May Abdel-Wahab.

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Naik, M., Marta, G.N. & Abdel-Wahab, M. Reirradiation of locally recurrent prostate cancer after primary radiotherapy. J Radiat Oncol 4, 149–156 (2015). https://doi.org/10.1007/s13566-015-0191-x

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  • DOI: https://doi.org/10.1007/s13566-015-0191-x

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