S170
Brachytherapy - Urology
ESTRO 2026
EBRT provided excellent local control, with only a small percentage demonstrating true intraprostatic recurrence. The predominance of distant failures reflects the intrinsically aggressive nature of high-risk disease, in which microscopic metastatic spread is likely to be present at diagnosis despite optimal local therapy. Such cases would benefit from early detection with PSMA-PET CT which offers superior sensitivity with mpMRI for local recurrences due to its superior soft tissue disease detection. Given that such patients recur much earlier than the rest of the cohort- attentive follow-up with timely functional imaging is essential to identify progression and implement early salvage strategies. Keywords: treatment failure, risk factors, recurrence type References: Nelson N. Stone, Richard G. Stock, Ida White, Pam Unger, Patterns of Local Failure Following Prostate Brachytherapy, The Journal of Urology, Volume 177, Issue 5, 2007, Pages 1759-1764, ISSN 0022- 5347.Raman S, Keyes M, Oh J, Rousseau E, Krauze A, Wilson D, Bénard F. Patterns of Prostate Cancer Recurrence After Brachytherapy Determined by Prostate-Specific Membrane Antigen-Positron Emission Tomography and Computed Tomography Imaging. Int J Radiat Oncol Biol Phys. 2022 Apr 1;112(5):1126-1134.Patel, Sagar A. et al. High-dose-rate (HDR) brachytherapy boost in combination with external beam radiotherapy for localized prostate cancer: An evidence-based consensus statement Brachytherapy, Volume 24, Issue 5, 644 - 662. HDR brachytherapy vs SBRT for localized prostate cancer: exploratory analysis of longitudinal QoL and PSA kinetics Paraskevi Menelaou 1 , Iosif Strouthos 2,3 , Paul Doolan 4 , Georgios Antorkas 4 , Yiannis Roussakis 4 , Costas Christofi 5 , Constantinos Zamboglou 2,3 , Konstantinos Ferentinos 2,3 1 Internal Medicine, German Oncology Center, Limassol, Cyprus. 2 Radiation Oncology, German Oncology Center, Limassol, Cyprus. 3 School of Medicine, Eurolean University Cyprys, Nicosia, Cyprus. 4 Medical Physics, German Oncology Center, Limassol, Cyprus. 5 Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus Digital Poster Highlight 3897
Digital Poster Highlight 3853 Patterns of Failure after HDR Brachytherapy Boost: Focus on clinical feature correlates. Ritika Abrol, Francesca Marie Wright, Angus Robinson, Ashok Nikapota Oncology, Royal Sussex County Hospital, Brighton, United Kingdom Purpose/Objective: To characterise recurrence patterns following high- dose-rate (HDR) brachytherapy boost in combination with external beam radiotherapy (EBRT), and to evaluate associations between recurrence type and clinical risk factors using multimodality imaging (CT, mpMRI and PET- Choline/PSMA). Material/Methods: A retrospective analysis was performed on 197 patients treated between 2014-2020 with a 15Gy HDR brachytherapy boost followed by EBRT with a median follow-up of 92 months. For monitoring- patients had serial PSA testing and imaging following biochemical failure (nadir + 2 ng/mL). Twenty patients (10.2%) developed biochemical recurrence and underwent multiparametric MRI (mpMRI) and PET- Choline/PSMA to determine recurrence type which was then divided into (i) local intraprostatic, (ii) regional nodal failure, or (iii) distant metastatic spread. Collected data was analysed via SPSS. Results: HDR boost treatment achieved excellent tumour control across the cohort. Recurrence occurred in 20 cases (10.2%), demonstrating high biochemical control in the treated population). Functional imaging- (18F- Choline PET-CT or PSMA PET) identified sites of recurrence, with metastatic disease noted in 18/20 (90%), predominantly involving mediastinal/retro- peritoneal nodal and osseous sites. 3/20 (15%) exhibited local recurrence in regional nodes- with only one with intra-prostatic disease identified on mpMRI highlighting good local control. Progression was mainly noted in patients with high-risk features (Gleason Grade Group ≥ 4, T3–T4 staging). On univariate logistic regression, nodal involvement (N1) at diagnosis was a statistically significant predictor of recurrence (OR 3.43, 95% CI 1.13–10.36, p=0.029). Gleason score demonstrated a strong trend toward significance (OR 1.4, p=0.076) and all recurrences occurred in T3-T4 staging categories suggesting strong association. The median duration of follow up for recurrences was 51 months compared to 92 months for the remaining cohort implying high-risk disease recurs sooner. Patients with recurrences were offered salvage radiotherapy or systemic treatment as appropriate. Conclusion: In our cohort of patients, HDR brachytherapy boost +
Purpose/Objective: High-dose-rate brachytherapy (HDR-BT) and
stereotactic body radiotherapy (SBRT) are definitive radiotherapy options for localized prostate cancer. While both achieve excellent tumour control, comparative patient-reported quality of life (QoL) data
Made with FlippingBook - Share PDF online