Salvage Brachytherapy and Interstitial Hyperthermia for Locally Recurrent Prostate Carcinoma Following Radiation Therapy

Inclusion Criteria: * Histologically-confirmed locally recurrent prostate cancer - biopsy performed \< 6 months before registration; * Histology: Adenocarcinoma, every Gleason score (2-10) * Initial treatment (EBRT) completed \> 24 months prior to biopsy; * Androgen deprivation therapy for prostate cancer should be discontinued at least 3 months prior to patient registration * Staging performed within 12 weeks prior to registration: * Local stage evaluated by DRE, TRUS or - if necessary - mpMRI (T1b, T1c, T2a, T2b, T2c, T3a, T3b); * Negative lymph nodes by imaging studies (at least one of these: choline PET scan, pelvic ± abdominal CT or MRI) or by lymphadenectomy (cN0 or pN0); * Negative bone scan (M0); * PSA-DT \> 6 months (PSA measurements taken of the 12 months prior to registration) * Zubrod Performance Scale 0-2 (Appendix V) International Prostate Symptoms Score (IPSS) \< 20 (Appendix VI), the IPSS score can be evaluated in patient on alpha-blockers; * Baseline gastrointestinal (GI) or genitourinary (GU) toxicity grade 0-1 as defined in Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. In TRUS volume study performed 0-4 weeks before registration patient meets eligibility criteria for prostate brachytherapy as follows: * Prostate/tumor volume \<60ml * The distance rear prostate edge - rectal mucosa \>5mm * Interference of pubic arch ruled out * If local stage T3b: it must be possible to cover by the brachytherapy dose cancer infiltration * Prostate lenght (from apex plane to base plane) ≤ 45mm (technical criterion for 915 MHz frequency antennas) * The patient is suitable for spinal or general anesthesia * Age \> 18 y. * Life expectancy \> 5 years * absence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial * The patient must sign a study-specific informed consent form before study registration Exclusion Criteria: * Severe, active comorbidities: * Decompensated congestive heart disease * Chronic obstructive pulmonary disease exacerbation, respiratory failure * Hepatic insufficiency resulting in coagulation defects or clinical jaundice * Other active malignancy or treatment of invasive or hematological malignancy * Evidence of extraprostatic disease at local recurrence: * Local stage T4 * Histologic or radiologic evidence of lymph node metastases (N1 or pN1) * Presence of distant metastases (M1) * Any of the following prior therapies: * TURP within 6 months prior to registration * Prostatic salvage cryosurgery performed at least 6 months before registration * HIFU performed at least 6 months before registration * Androgen deprivation therapy within 3 months prior to registration * Baseline gastrointestinal (GI) or genitourinary (GU) toxicity grade ≥ 2 as defined in Common Terminology Criteria for Adverse Events (CTCAE) version 4.0.