Bladder wall recurrence of prostate cancer after high-dose-rate brachytherapy

被引:5
作者
Raleigh, David R. [1 ]
Hsu, I-Chow [1 ]
Braunstein, Steve [1 ]
Chang, Albert J. [1 ]
Simko, Jeffry P. [1 ,2 ,3 ]
Roach, Mack, III [1 ,3 ]
机构
[1] Univ Calif San Francisco, Dept Radiat Oncol, San Francisco, CA 94143 USA
[2] Univ Calif San Francisco, Dept Anat Pathol, San Francisco, CA 94143 USA
[3] Univ Calif San Francisco, Dept Urol, San Francisco, CA 94143 USA
关键词
Brachytherapy; Prostate cancer; Tumor seeding; Circulating tumor cells; Androgen deprivation; MALIGNANT CYTOLOGICAL WASHINGS; ORGAN CONFINED DISEASE; RADICAL PROSTATECTOMY; NEEDLE-BIOPSY; POSSIBLE MECHANISM; SURGICAL-TREATMENT; LOCAL RECURRENCE; SPECIMENS; ADENOCARCINOMA; NECK;
D O I
10.1016/j.brachy.2014.11.008
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
PURPOSE: Prostate cancer seeding after needle biopsy has been reported in the perineum, rectal wall, and periprostatic soft tissue. In this article, we report the results of a localized prostate cancer recurrence in the bladder following protrusion of a single high-dose-rate brachytherapy catheter through the bladder wall at the ultimate site of failure. METHOD AND MATERIALS: A 62-year-old man with high-risk prostate adenocarcinoma was treated with long-term androgen deprivation therapy, intensity-modulated radiation, and high-dose-rate brachytherapy boost. He developed biochemical recurrence 4 years after treatment, and a CT scan of the pelvis revealed a nodule in the posterior, inferior bladder wall. RESULTS: Surgical pathology following transurethral resection of tumor within the bladder was consistent with high-grade prostate adenocarcinoma. The patient's prostate-specific antigen level fell to the range of normal postoperatively, and whole body imaging, including a multi-parametric MRI of the prostate with diffusion and spectroscopy, failed to reveal any other sites of disease. Review of the CT scan obtained for dosimetry at the time of brachytherapy demonstrated a lone catheter protruding through the bladder wall at the site of eventual recurrence. The tumor recurred in the bladder 12 months later, once more without evidence of disease within the prostate itself or distantly, and the patient was started on salvage androgen deprivation therapy. CONCLUSIONS: This case is the first report of prostate cancer recurrence in the bladder wall after brachytherapy and raises questions about prostate cancer biology, brachytherapy technique, and the timing of brachytherapy boost relative to whole pelvic radiotherapy for prostate cancer. Published by Elsevier Inc. on behalf of American Brachytherapy Society.
引用
收藏
页码:185 / 188
页数:4
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