{
  "abstract": "Salvage high-dose-rate brachytherapy (sHDR-BT) is an effective option for radiorecurrent prostate cancer. This study aimed to compare the efficacy and toxicity of two sHDR-BT fractionation schedules and identify factors associated with treatment outcomes. We retrospectively analyzed 223 patients treated with sHDR-BT between 2008 and 2021. Patients received either 3 × 10 Gy (n = 150) or 2 × 13 Gy (n = 73). Median follow-up was significantly longer in the 3 × 10 Gy group (125 vs 79 months, P < .001). Apart from a higher frequency of high-grade disease (P = .02) and nodal/distant recurrence (P < .001) in the 2 × 13 Gy cohort, baseline characteristics were comparable between the groups. The Kaplan-Meier estimator, log-rank test, and Cox proportional hazards models were used in statistical analysis. In the entire cohort, the 5-year overall survival rate exceeded 75%, and the median biochemical control was 12.6 years. Factors independently associated with worse oncological outcomes included primary International Society of Urological Pathology grade 5, nodal or distant recurrence, castration resistance, and shorter interval from primary therapy to recurrence. Use of androgen deprivation therapy (ADT) reduced the risk of local failure (P = .04). Late genitourinary and gastrointestinal toxicity was acceptable and comparable between the subgroups (P = .6 and P = .4, respectively). In the no-ADT subgroup (n = 83), median overall survival was 113 months, and median ADT-free survival reached 88 months. Regardless of the fractionation schedule, sHDR-BT is an effective option for selected patients with localized, noncastration-resistant recurrence, characterized by relatively low toxicity. Castration resistance and regional or distant metastases strongly limit efficacy. In appropriately selected patients, salvage therapy can substantially delay the initiation of ADT.",
  "abstract_shown": true,
  "affiliations": [
    "Brachytherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland.",
    "Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland.",
    "Department of Systems Biology and Engineering, Silesian University of Technology, Gliwice, Poland.",
    "Radiotherapy Planning Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Magdalena Stankiewicz"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Agata Wilk"
    },
    {
      "affs": [
        1
      ],
      "name": "Marcela Krzempek"
    },
    {
      "affs": [
        0
      ],
      "name": "Sylwia Kellas-Ślęczka"
    },
    {
      "affs": [
        3
      ],
      "name": "Marta Szlag"
    },
    {
      "affs": [
        0
      ],
      "name": "Piotr Wojcieszek"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7nksvvbdjkmda.bib",
  "cited_by": 0,
  "doi": "10.1016/j.adro.2026.102210",
  "fulltext_url": "https://europepmc.org/articles/PMC13744313",
  "id": "7nksvvbdjkmda",
  "issns": [
    "2452-1094"
  ],
  "landing_url": "https://europepmc.org/article/MED/42999902",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2748|Prostate Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7213455140",
  "pdf_url": "https://europepmc.org/articles/PMC13744313?pdf=render",
  "pmcid": "PMC13744313",
  "pmid": "42999902",
  "published": "2026-09-17",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7nksvvbdjkmda.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T15:20:41Z",
      "native_id": "MED:42999902",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42999902"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2748|Prostate Cancer Diagnosis and Treatment",
      "subfield": "general"
    }
  ],
  "title": "Salvage High-Dose-Rate Brachytherapy for Localized Prostate Cancer Recurrence: A Comparative Analysis of 2 Fractionation Schedules-Single-Institution Study of 223 Patients.",
  "title_text": "Salvage High-Dose-Rate Brachytherapy for Localized Prostate Cancer Recurrence: A Comparative Analysis of 2 Fractionation Schedules-Single-Institution Study of 223 Patients.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T15:20:41Z",
  "url": "https://research.draconitic.com/paper/7nksvvbdjkmda",
  "venue": "Advances in radiation oncology",
  "versions": []
}