Marieke van Son

171 RE-SALVAGE FOCAL HDR-BT Figure 7 – PSA value timeline Timeline showing the course of PSA values over time. The first MRI-guided focal salvage HDR-BT was performed at a PSA level of 6.7 ng/ml. The second MRI-guided focal salvage HDR-BT was performed at a PSA-level of 4.6 ng/ml. DISCUSSION With local salvage treatments, toxicity is a major issue that must be weighed against the benefits of delaying the onset of metastatic disease or, in particular cases, providing a cure. Focal treatment aimed at the tumor lesion instead of the whole prostate gland is a novel development in the span of salvage treatments. Powered by technical advances in diagnostic modalities and the increasing possibilities of MRI guidance before and during treatment, targeted therapy aims to reduce toxicity. With limited toxicity, repet- itive salvage treatment could be possible for future local recurrences and ADT (and its side effects) could be postponed or even prevented. This report describes the first case of repeat MRI-guided focal salvage HDR-BT for prostate cancer recurrence. After both focal treatments, the patient experienced minor toxicity (maximum grade 2), which was limited to urinary retention and frequency symp- toms, transient flatulence complaints, and a temporary decrease in erectile function. Because of the relatively short follow-up time after the second treatment, there is no information on long-term toxicity yet. However, results with regard to acute toxicity 9