New in Advances in Radiation Oncology: MRI-guided whole-gland salvage HDR brachytherapy for radiorecurrent prostate cancer. Prospective phase II, 30 patients, 21 Gy to the whole prostate plus 27 Gy to the MR-defined target over 2 implants, no ADT, median follow-up 72 months. Key finding: bRFS was 73.0% at 3 years but 24.8% at 5 years (median 44.1 months). Toxicity was low: no acute grade 3-5 events and one late grade 3 (3.3%), with 13% needing temporary catheterization. IPSS and EPIC-50 scores returned to baseline. Why it matters: this is one of the few prospective salvage HDR datasets with real long-term follow-up and no ADT, so the biochemical curve is not blurred by hormonal suppression. It is the cleanest look we have at what salvage brachytherapy alone actually delivers. Important caveat: 78% of biochemical failures occurred at the treated target volume, and all 9 patients with persistent disease on post-HDR MRI eventually relapsed. With n=30, 30% Gleason 8-10 at recurrence, and 77% staged before PSMA-PET, this is a signal about dose and patient selection, not a verdict on the modality. Bottom line: whole-gland salvage HDR is safe and preserves quality of life, but 2 fractions without ADT does not look durable. The next questions are fractionation, dose to the recurrent lesion, and who should be getting systemic therapy alongside salvage. doi.org/10.1016/j.adro.2026.… @ASTRO_org #RadOnc #OncTwitter #PCSM