What you see is what you get.

As we increasingly utilize advanced imaging modalities like fluciclovine or PSMA PET, we’ll have a lot more prostate cancer recurrences we can see. And what we can see, we can radiate. RTOG 0526 was a phase 2 trial of salvage low dose rate (LDR) brachytherapy for men who initially received dose-escalated external beam radiation for low to intermediate risk disease. All had biopsy-proven local recurrences over 30 months out from treatment with PSA ≤10. Treatment consisted of seed implants with a prescription dose of 140 Gy with I-125 or 120 Gy with Pd-103. The primary endpoint of at least grade 3 late toxicity was experienced by 14% of patients with no grade 4 toxicity. Unfortunately, there weren’t any efficacy outcomes yet. TBL: Salvage LDR brachytherapy after external beam radiation appears to be a safe treatment option with acceptable toxicity. | Crook, Int J Radiat Oncol Biol Phys 2018