Optimal treatment for patients with only local
prostate cancer recurrence after external beam
radiation therapy (EBRT) failure remains unclear. Possible curative treatments are radical
prostatectomy,
cryosurgery, and
brachytherapy. Several single institution series proved that high-dose-rate
brachytherapy (HDRBT) and pulsed-dose-rate
brachytherapy (PDRBT) are reasonable options for this group of patients with acceptable levels of genitourinary and gastrointestinal toxicity. A standard dose prescription and scheme have not been established yet, and the literature presents a wide range of fractionation protocols. Furthermore,
hyperthermia has shown the potential to enhance the efficacy of
re-irradiation. Consequently, a prospective trial is urgently needed to attain clear structured prospective data regarding the efficacy of salvage
brachytherapy with adjuvant
hyperthermia for locally recurrent
prostate cancer. The purpose of this report is to introduce a new prospective phase II trial that would meet this need. The primary aim of this prospective phase II study combining
Iridium-192 brachytherapy with interstitial
hyperthermia (IHT) is to analyze toxicity of the combined treatment; a secondary aim is to define the efficacy (bNED, DFS, OS) of salvage
brachytherapy. The dose prescribed to PTV will be 30 Gy in 3 fractions for HDRBT, and 60 Gy in 2 fractions for PDRBT. During IHT, the prostate will be heated to the range of 40-47°C for 60 minutes prior to
brachytherapy dose delivery. The protocol plans for treatment of 77 patients.