Salvage high-dose-rate brachytherapy for prostate cancer persistence after brachytherapy: repeated use of a polyethylene glycol hydrogel spacer

Rodrigo Hepp; Thilo Eggert; Georg Schabl; Lars Herberholz; Tim Petry; Razvan Galalae

doi:10.5114/jcb.2018.75602

eISSN: 2081-2841
ISSN: 1689-832X

Journal of Contemporary Brachytherapy

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2/2018
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abstract:

Case report

Salvage high-dose-rate brachytherapy for prostate cancer persistence after brachytherapy: repeated use of a polyethylene glycol hydrogel spacer

Rodrigo Hepp

,

Thilo Eggert

,

Georg Schabl

,

Lars Herberholz

,

Tim Petry

,

Razvan Galalae

J Contemp Brachytherapy 2018; 10, 2: 169–173

DOI: https://doi.org/10.5114/jcb.2018.75602

Online publish date: 2018/04/30

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AMA

Hepp R, Eggert T, Schabl G, Herberholz L, Petry T, Galalae R. Salvage high-dose-rate brachytherapy for prostate cancer persistence after brachytherapy: repeated use of a polyethylene glycol hydrogel spacer. Journal of Contemporary Brachytherapy. 2018;10(2):169-173. doi:10.5114/jcb.2018.75602.

APA

Hepp, R., Eggert, T., Schabl, G., Herberholz, L., Petry, T.,  & Galalae, R. (2018). Salvage high-dose-rate brachytherapy for prostate cancer persistence after brachytherapy: repeated use of a polyethylene glycol hydrogel spacer. Journal of Contemporary Brachytherapy, 10(2), 169-173. https://doi.org/10.5114/jcb.2018.75602

Chicago

Hepp, Rodrigo, Thilo Eggert, Georg Schabl, Lars Herberholz, Tim Petry,  and Razvan Galalae. 2018. "Salvage high-dose-rate brachytherapy for prostate cancer persistence after brachytherapy: repeated use of a polyethylene glycol hydrogel spacer". Journal of Contemporary Brachytherapy 10 (2): 169-173. doi:10.5114/jcb.2018.75602.

Harvard

Hepp, R., Eggert, T., Schabl, G., Herberholz, L., Petry, T.,  and Galalae, R. (2018). Salvage high-dose-rate brachytherapy for prostate cancer persistence after brachytherapy: repeated use of a polyethylene glycol hydrogel spacer. Journal of Contemporary Brachytherapy, 10(2), pp.169-173. https://doi.org/10.5114/jcb.2018.75602

MLA

Hepp, Rodrigo et al. "Salvage high-dose-rate brachytherapy for prostate cancer persistence after brachytherapy: repeated use of a polyethylene glycol hydrogel spacer." Journal of Contemporary Brachytherapy, vol. 10, no. 2, 2018, pp. 169-173. doi:10.5114/jcb.2018.75602.

Vancouver

Hepp R, Eggert T, Schabl G, Herberholz L, Petry T, Galalae R. Salvage high-dose-rate brachytherapy for prostate cancer persistence after brachytherapy: repeated use of a polyethylene glycol hydrogel spacer. Journal of Contemporary Brachytherapy. 2018;10(2):169-173. doi:10.5114/jcb.2018.75602.

Purpose
The aim of this study is to determine if a repeated hydrogel injection in a previously irradiated patient prior to salvage high-dose-rate brachytherapy (HDR-BT) is feasible.

Material and methods
A 61-year-old man with an organ confined (cT1c cN0 cM0, Gleason score 3 + 3 = 6, initial prostate-specific antigen [PSA] 7.9 ng/ml) prostate cancer was previously treated with HDR-BT (3 fractions of 11.5 Gy every 2nd week) after hydrogel injection to reduce the rectal dose. Ten months after, an isolated local persistence was seen on a PSMA PET-CT. Nadir PSA was 2.0 ng/ml, 3 months after treatment and was 3.95 ng/ml by the re-treatment. Salvage therapy consisted of HDR-BT (3 fractions of 9 Gy every 2nd week) with a simultaneous integrated boost to the residual region. Again, a hydrogel injection (10 ml) was applied to reduce the rectal dose prior to the treatment.

Results
Both hydrogel injection and salvage HDR-BT could be applied without any significant complications or toxicity. A good PSA response was observed with a nadir of 0.42 ng/ml, twelve months after salvage therapy. Acute toxicity (max grade II) resolved within 2 days after treatment.

Conclusions
The use of a hydrogel prior to salvage HDR-BT in a patient previously treated with HDR-BT is feasible and could help reduce the rectal exposure in the salvage setting.

keywords:

Salvage high-dose-rate brachytherapy for prostate cancer persistence after brachytherapy: repeated use of a polyethylene glycol hydrogel spacer

Rodrigo Hepp , Thilo Eggert , Georg Schabl , Lars Herberholz , Tim Petry , Razvan Galalae

brachytherapy, hydrogel, prostate cancer, rectal spacer, salvage

Rodrigo Hepp

,

Thilo Eggert

,

Georg Schabl

,

Lars Herberholz

,

Tim Petry

,

Razvan Galalae