Just ran across this article. This link is just to an abstract so few details are provided, but it is quite current.
High-dose-rate brachytherapy as salvage modality for locally recurrent prostate cancer after definitive radiotherapy : A systematic review.The one thing that stands out to me is "
Late grade 3 genitourinary and gastrointestinal toxicity was 0-32% and 0-5.1%, respectively.".
Grade 3 genitourinary toxicity means "
Frequency with urgency and nocturia hourly or more frequenty / dysuria, pelvis pain or bladder spasm requiring regular, frequent narcotic / gross hematuria
with/without clot passage", according to
Radiation Oncology/Toxicity grading/RTOG.
It would be interesting to see the actual distribution of that toxicity, since up to 32% is a pretty high rate of something that sounds rather unpleasant. The abstract also doesn't say what dose levels or types of primary radiation were used. In another link I posted recently about
SBRT salvage treatment they recognized that higher primary doses were associated with higher toxicity after salvage SBRT (not surprising). It seems reasonable that a similar relationship could occur with HDR BT since it's also a radiation treatment.
But otherwise, they're optimistic about
using salvage HDR even for those who had primary radiation therapy, though they do also say, "
The 5‑year BC ranged from 18-77%.". (BC means biochemical control, so it's the PSA level). That's also quite a range, but this is a meta study, a study of studies, so a wide variety of treatment plans were involved.
Something to consider if one ends up in that situation.