High-Dose-Rate brachytherapy for salvage treatment of prostate cancer recurrence post-prostatectomy and radiotherapy: A multicenter retrospective analysis (HDR-REPOPRA) by UroGEC
Kluska A, Chyrek AJ, Guix B, Willisch P, Soror T, Bilski M, Garcia I, Guix T, Vázquez B, Burchardt W, Lelek P, Merten R, Strnad V, Strouthos I, Terlizzi M, Büchser D, Blanchard P, Iturriaga AG, Wojcieszek P (2025)
Publication Type: Journal article
Publication year: 2025
Journal
Book Volume: 212
Article Number: 111145
DOI: 10.1016/j.radonc.2025.111145
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.
Authors with CRIS profile
Involved external institutions
Wielkopolskie Centrum Onkologii (WCO) / Greater Poland Cancer Centre
Poland (PL)
Hospital do Meixoeiro
Spain (ES)
Universität zu Lübeck
Germany (DE)
NU-MED Center for Diagnostics and Oncology Therapy Zamość Sp. z o.o.
Poland (PL)
Maria Skłodowska-Curie Institute of Oncology / Centrum Onkologii–Instytut im. Marii Skłodowskiej-Curie w Warszawie
Poland (PL)
European University Cyprus (EUC) / Ευρωπαϊκό Πανεπιστήμιο Κύπρου
Cyprus (CY)
Research Center in Epidemiology and Population Health / Centre de recherche en Epidémiologie et Santé des Populations (CESP)
France (FR)
Osakidetza
Spain (ES)
Poland (PL)
Hospital do Meixoeiro
Spain (ES)
Universität zu Lübeck
Germany (DE)
NU-MED Center for Diagnostics and Oncology Therapy Zamość Sp. z o.o.
Poland (PL)
Maria Skłodowska-Curie Institute of Oncology / Centrum Onkologii–Instytut im. Marii Skłodowskiej-Curie w Warszawie
Poland (PL)
European University Cyprus (EUC) / Ευρωπαϊκό Πανεπιστήμιο Κύπρου
Cyprus (CY)
Research Center in Epidemiology and Population Health / Centre de recherche en Epidémiologie et Santé des Populations (CESP)
France (FR)
Osakidetza
Spain (ES)
How to cite
APA:
Kluska, A., Chyrek, A.J., Guix, B., Willisch, P., Soror, T., Bilski, M.,... Wojcieszek, P. (2025). High-Dose-Rate brachytherapy for salvage treatment of prostate cancer recurrence post-prostatectomy and radiotherapy: A multicenter retrospective analysis (HDR-REPOPRA) by UroGEC. Radiotherapy and Oncology, 212. https://doi.org/10.1016/j.radonc.2025.111145
MLA:
Kluska, Adam, et al. "High-Dose-Rate brachytherapy for salvage treatment of prostate cancer recurrence post-prostatectomy and radiotherapy: A multicenter retrospective analysis (HDR-REPOPRA) by UroGEC." Radiotherapy and Oncology 212 (2025).
BibTeX: Download