Long-Term Outcomes of a Prospective Study on Magnetic Resonance Imaging-Guided Whole-Gland Salvage High-Dose-Rate Prostate Brachytherapy for Locally Recurrent Prostate Cancer
In brief
Salvage prostate brachytherapy kept 70% of patients off hormone therapy at five years
In this prospective study of 30 men with prostate cancer recurring after radiation, 69.6% remained free of hormone therapy at five years, but only 24.8% were free of prostate-specific antigen progression. Severe toxicity was uncommon, affecting one patient, while most relapses involved the treated prostate target; the small study leaves long-term disease control uncertain.
- Journal
- Advances in radiation oncology (Q1)
- Published
- 21 August 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Hsin-Pei Hu, Gerard Morton, Andrew Loblaw, Chia-Lin Tseng, Jure Murgic, Ananth Ravi, et al.
- PMID
- 42935525
- DOI
- 10.1016/j.adro.2026.102168
Why clinicians should know about it
- Picked for Radiology, Radiation Oncology, Nuclear Medicine, Medical Physics and Imaging (paper of the day, 1 November 2026): Prospective MRI-guided salvage HDR brachytherapy with long-term outcomes
- Picked for Radiation Oncology (paper of the day, 1 November 2026): Long‑term outcomes of salvage HDR prostate brachytherapy
Abstract
PURPOSE: Whole-gland salvage high-dose-rate (HDR) prostate brachytherapy is an emerging option for radiorecurrent prostate cancer. However, long-term prospective data remain limited. This report presents the long-term results of our prospective study on the toxicities, health-related quality of life, and efficacy of whole-gland HDR prostate brachytherapy. METHODS AND MATERIALS: Patients with biopsy-confirmed, magnetic resonance (MR)-visible local recurrent prostate cancer after previous external beam radiation therapy (EBRT) were eligible. Patients underwent MR-assisted, ultrasound-based whole-gland HDR prostate brachytherapy with a prescription dose of 21 Gy to the entire prostate and 27 Gy to the MR-defined intraprostatic target volume (TV) divided over 2 implants separated by 1 to 2 weeks. Adjuvant androgen deprivation therapy was not used. RESULTS: Thirty patients were enrolled in the study. Median follow-up from salvage HDR was 72.0 months (10.7-121.5 months). Most patients (93%) had initial EBRT doses at conventional fractionation. The pre-HDR median prostate-specific antigen was 3.67 ng/mL (0.56-11.01 ng/mL). Seven (23.3%) were staged with prostate-specific membrane antigen positron emission tomography. Four (13%) required temporary urinary catheterization. There was only 1 (3.3%) grade 3 to 5 toxicity-a late grade 3 genitourinary toxicity. The prostate-specific antigen progression-free survival and freedom from androgen deprivation therapy rates were 73.0% and 93.0% at 3 years, and 24.8% and 69.6% at 5 years, respectively. Of the 26 patients who had a post-HDR MR imaging (median, 415 days), 9 (35%) had persistent disease. Of the 23 (77%) patients who had prostate-specific antigen relapse, 18 (78%) patients had disease at the TV confirmed by MR imaging, prostate-specific membrane antigen positron emission tomography, or targeted biopsy. CONCLUSIONS: Whole-gland salvage HDR brachytherapy with intraprostatic boost is well tolerated. Progression after salvage treatment was associated with local failure.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.