Salvage brachytherapy for seminal vesicle recurrence after initial brachytherapy for prostate cancer: a case report

BMC Research Notes

Kiyohide Fujimoto¹  Noboru Konishi³  Masatoshi Hasegawa⁴  Akihide Hirayama²  Yosuke Morizawa¹  Isao Asakawa⁴  Nobumichi Tanaka¹  Shunta Hori¹ 

[1] Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan;Department of Urology, Nara Hospital of Kinki University, Nara, Japan;Department of Pathology, Nara Medical University, Nara, Japan;Department of Radiation Oncology, Nara Medical University, Nara, Japan

关键词: Prostate cancer;    Seminal vesicle recurrence;    Salvage brachytherapy;   

Others  :  1125808
DOI  :  10.1186/1756-0500-7-760

 received in 2014-06-03, accepted in 2014-10-13,  发布年份 2014

【 摘 要 】

Background

To report the efficacy and safety of salvage brachytherapy for seminal vesicle recurrence after initial brachytherapy in a patient with prostate cancer. As far as we know, this is a first report of salvage brachytherapy for seminal vesicle recurrence in Japan.

Case presentation

A 70-year-old Japanese man with low-risk prostate cancer received low-dose-rate brachytherapy. Forty-two months after the seed implantation, he showed biochemical recurrence based on the nadir + 2 ng/mL definition. The prostate specific antigen (PSA) level was 5.11 ng/mL at 58 months after seed implantation. A saturation biopsy of the prostate showed no recurrence. Systemic screening also showed no distant metastases. However, T2-weighted magnetic resonance imaging (MRI) demonstrated a low intensity area at the base of the right seminal vesicle, which was strongly suggestive of recurrence. Sixty months after the initial therapy, a seminal vesicle biopsy confirmed recurrence with a Gleason score of 4 + 3 before salvage brachytherapy was performed. The prescribed dose was 145 Gy, the same as the dose of the initial therapy. One month later, the PSA level had rapidly declined to 0.898 ng/mL without androgen deprivation therapy. Ten months after the salvage brachytherapy, the PSA level reached 0.078 ng/mL. No adverse events were seen during the follow-up period.

Conclusions

We experienced a patient who was successfully treated with salvage brachytherapy for seminal vesicle recurrence. Salvage brachytherapy is one of the promising therapeutic options for recurrence after initial brachytherapy.

【 授权许可】

   
2014 Hori et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Koutrouvelis P, Hendricks F, Lailas N, Gil-Montero G, Sehn J, Khawand N, Bondy H, Katz S: Salvage reimplantation in patient with local recurrent prostate carcinoma after brachytherapy with three dimensional computed tomography-guided permanent pararectal implant. Technol Cancer Res Treat 2003, 4:339-344.
• [2]Burri RJ, Stone NN, Unger P, Stock RG: Long-term outcome and toxicity of salvage brachytherapy for local failure after initial radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phy 2010, 77:1338-1344.
• [3]Wong WW, Buskirk SJ, Schild SE, Prussak KA, Davis BJ: Combined prostate brachytherapy and short-term androgen deprivation therapy as salvage therapy for locally recurrent prostate cancer after external beam irradiation. J Urol 2006, 176:2020-2024.
• [4]Nguyen PL, Chen MH, D’Amico AV, Tempany CM, Steele GS, Albert M, Cormack RA, Carr-Locke DL, Bleday R, Suh WW: Magnetic resonance image-guided salvage brachytherapy after radiation in select men who initially presented with favorable-risk prostate cancer: a prospective phase 2 study. Cancer 2007, 110:1485-1492.
• [5]Lee HK, Adams MT, Motta J: Salvage prostate brachytherapy for localized prostate cancer failure after external beam radiation therapy. Brachytherapy 2008, 1:17-21.
• [6]Aaronson DS, Yamasaki I, Gottschalk A, Speight J, Hsu IC, Pickett B, Roach M 3rd, Shinohara K: Salvage permanent perineal radioactive-seed implantation for treating recurrence of localized prostate adenocarcinoma after external beam radiotherapy. BJU Int 2009, 104:600-604.
• [7]Moman MR, van der Poel HG, Battermann JJ, Moerland MA, van Vulpen M: Treatment outcome and toxicity after salvage 125-I implantation for prostate cancer recurrences after primary 125-I implantation and external beam radiotherapy. Brachytherapy 2010, 9:119-125.