Focal Salvage HDR Brachytherapy for the Treatment of Prostate Cancer

Inclusion Criteria: * Biopsy-confirmed locally recurrent prostate adenocarcinoma \> 30months after the completion of XRT, SBRT, LDR or HDR brachytherapy boost with XRT, or LDR or HDR brachytherapy as monotherapy by a stereotactic transperineal biopsy * Staging T2-weighted, DWI and DCE-MRI that demonstrates solitary recurrence confined to prostate, and correlates with stereotactic transperineal biopsy * Staging CT or MRI (abdomen and pelvis) and bone scan are negative for metastases * American Urological Association Symptom Index Score (ie. IPSS) \< 15 * Baseline (post-XRT) serum PSA \< 10 ng/mL * Prostate volume as measured by transrectal ultrasound (TRUS) \< 50cc * ECOG performance status 0-1 Exclusion Criteria: * Any of the following prior therapies: transurethral resection of the prostate (TURP), radionuclide (permanent or temporary implantation) prostate brachytherapy, prostatectomy or prostatic cryosurgery, HIFU (high-intensity focused ultrasound), bilateral orchiectomy, chemotherapy for prostatic carcinoma * Evidence of castrate resistance (defined as PSA \> 3 ng/mL while testosterone is \< 1.7 nmol/L). Patients could have been on combined androgen blockade with initial radiotherapy but are excluded if this was started due to PSA progression.