Would you offer re-irradiation for a prostate local recurrence after I-125 seed implant >10 years ago in a healthy young patient with life expectancy >15 years?

While I think salvage re-irradiation does have the potential to become a routine option in such situations, I think further study is required to define both the efficacy and toxicity profile prior to establishing it as such. The current state of knowledge is based on limited information, as Dr. @Dr....

As advanced imaging has helped us better identify patients with local-only disease recurrence, the question of local therapies after prior radiation looms larger. ASCO GU 2024 had an excellent panel discussing surgical, focal, and radiation options for recurrences. Minor self-promotion, but I also t...

I would not. There is not enough evidence on safety for me in the setting of prior brachytherapy, and this case is further complicated by the presence of seeds that often obscure prostate imaging with MRI or PSMA PET.

@Dr. First Last and @Dr. First Last have nicely summarized the evidence. Succinctl...