Efficacy and safety of salvage brachytherapy for local recurrence after radiotherapy for prostate cancer

Merten R, Strnad V, Lotter M, Kreppner S, Frei C, Schweizer C, Fietkau R, Corradini S, Karius A, Schubert P (2026)

Publication Type: Journal article

Publication year: 2026

Journal

DOI: 10.1016/j.brachy.2026.04.007

Abstract

Purpose: To evaluate the efficacy and safety of salvage brachytherapy (SBT) as a curative treatment option for patients with locally recurrent prostate cancer after prior radiation therapy. Materials and Methods: Between 2009 and 2023, we analyzed 108 prostate cancer patients with local recurrent after radiotherapy. SBT was performed as a sole treatment using either HDR (high dose rate) brachytherapy with a total dose of 30 Gy in three fractions (78.0 Gy EQD2 α/β=3 Gy) or PDR (pulse dose rate) brachytherapy with a total dose of 60 Gy in two sessions (71.5 Gy EQD2 α/β=3 Gy), with a three-week interval between sessions in both regimens. Results: Median follow-up was 41 months (range 6–173). Median interval between initial radiation and salvage brachytherapy was 66 months (range 18–214). The 5-year cumulative incidence of local recurrence was 17.0%. Local relapse was observed in 15 patients (13.8%). The 2- and 5-year biochemical disease-free survival according to the Phoenix definition were 83.6% and 59.9%. The 2- and 5-year progression-free survival were 77.0% and 53.2%; overall survival rates were 96.9% and 87.4%, respectively. Grade ≥ 3 urinary toxicity was uncommon, with 2/93 (2.1%) patients requiring transurethral resection and 6/93 (6.5%) long-term catheterization. Most patients had grade 0–1 incontinence; grade 2 and grade ≥ 3 occurred in 13/79 (16.5%) and 7/79 (8.8%) at 24 months. Proctitis was rare; no grade ≥ 3. Conclusions: Salvage brachytherapy offers an effective and well-tolerated curative option for patients with locally recurrent prostate cancer after prior radiation therapy.

Authors with CRIS profile

Ricarda Merten Department of Radiation Oncology Vratislav Strnad Department of Radiation Oncology Stephan Kreppner Department of Radiation Oncology Charlotte Frei Department of Radiation Oncology Claudia Schweizer Department of Radiation Oncology Rainer Fietkau Lehrstuhl für Strahlentherapie Stefanie Corradini Department of Radiation Oncology Andre Karius Department of Radiation Oncology Philipp Schubert Department of Radiation Oncology

How to cite

APA:

Merten, R., Strnad, V., Lotter, M., Kreppner, S., Frei, C., Schweizer, C.,... Schubert, P. (2026). Efficacy and safety of salvage brachytherapy for local recurrence after radiotherapy for prostate cancer. Brachytherapy. https://doi.org/10.1016/j.brachy.2026.04.007

MLA:

Merten, Ricarda, et al. "Efficacy and safety of salvage brachytherapy for local recurrence after radiotherapy for prostate cancer." Brachytherapy (2026).

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