Updated results of MR-assisted focal salvage HDR prostate brachytherapy: a prospective study
Bibliographic record
Abstract
BACKGROUND AND PURPOSE: Focal salvage high dose-rate (HDR) prostate brachytherapy has emerged as a standard option for radiorecurrent prostate cancer. However, long-term prospective data remains limited. Our prospective study aimed to explore the toxicities, health-related quality of life (HRQOL) and efficacy of focal salvage HDR prostate brachytherapy. This report represents the updated results of the final cohort of patients. MATERIAL AND METHODS: Patients with biopsy-confirmed, MR-visible local recurrent prostate cancer after previous external-beam radiotherapy (XRT) and/or brachytherapy were eligible. MR-assisted, ultrasound-based focal HDR prostate brachytherapy with a prescription dose of 27 Gy in 2 fractions separated by 1-2 weeks apart was delivered. Adjuvant androgen deprivation therapy (ADT) was not used. RESULTS: 59 patients were enrolled in the study. Median follow up from salvage HDR was 54 months (11-132). The initial treatment was XRT only in 20 (34 %) and brachytherapy +/- XRT in 39 (66 %). The pre-HDR median PSA was 4.13 ng/mL (1.30-11.63). Twenty-five (42 %) were staged with a PSMA PET scan. One patient (1.7 %) required temporary urinary catheterization. There was only 1 grade 3-5 toxicity, a late grade 3 GU toxicity. Three-year biochemical failure-free survival and freedom from ADT or repeat salvage therapy rate was 54 % and 82 %, respectively. Of the 55 patients who had a post-HDR MRI (median 464 days), 46 (84 %) patients had a complete response and 9 had persistent disease. 8 (15 %) patients recurred elsewhere in the prostate. CONCLUSION: Our toxicity and PSA failure-free results suggest that focal gland salvage HDR brachytherapy is well tolerated and effective. CLINICALTRIALS: gov identifier NCT01583920.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".