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When Prostate Brachytherapy Fails: A Case Report and Discussion

^a University of California, Berkeley, California, USA, and Harvard Medical School, Boston, Massachusetts, USA; ^b Department of Radiation Oncology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA; ^c Department of Radiation Oncology, Beth Israel/Deaconess Medical Center, Harvard Medical School, and Boston Veterans Health Affairs Medical Centers, Boston, Massachusetts, USA

Key Words. Prostate cancer • Brachytherapy • Prostate-specific antigen failure • Local recurrence

Correspondence: Richard H. Matthews, M.D., Ph.D., Beth Israel/Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Boston, MA 02215, USA. Telephone: 617-232-9500, ext. 4457 or 5628; Fax: 617-278-4478; e-mail: rhmatthews{at}comcast.net

For appropriately selected brachytherapy patients, prostate-specific antigen failure is uncommon. Our patient experienced biochemical failure after ¹²⁵I brachytherapy treatment for low-risk prostate adenocarcinoma. We suggest neoadjuvant/adjuvant hormonal therapy combined with pelvic external-beam radiation therapy as a reasonable salvage treatment. At the 2-year follow-up, he is apparently doing well. With limited data available, salvage management for this situation is presently investigational.