BACKGROUND: To evaluate late urinary (GU) and gastrointestinal (GI) adverse events (AEs) and biochemical control of disease after high-dose rate brachytherapy (HDR-BT) in locally advanced prostate cancer.
PATIENTS AND METHODS: 227 consecutive patients were treated with 3×10.5Gy (n=109) or 2×13Gy (n=118) HDR-BT alone. Biochemical failure was assessed using the Phoenix definition of PSA nadir+2μg/l and late AEs using the RTOG scoring system and the International Prostate Symptom Score (IPSS).
RESULTS: Kaplan-Meier estimates and prevalence of late events indicate that urinary, bowel and IPSS symptoms are higher after 31.5Gy than after 26Gy, however differences are significant only for Grade 1 and 2 urinary toxicity. Kaplan-Meier estimates of morbidity are consistently and considerably higher than time-point estimates of prevalence; which reflects the transient nature of most symptoms. At 3years 93% and 97% of patients treated with 26 and 31.5Gy, respectively, were free from biochemical relapse (p=0.5) and 91% for the latter regimen at 5years. In univariate and multivariate analysis risk-category was the only significant predictor of relapse (p< 0.03).
CONCLUSION: These HDR-BT schedules achieved high levels of biochemical control of disease in patients with advanced prostate cancer with few severe complications seen throughout the first 3years.
Hoskin P, Rojas A, Ostler P, Hughes R, Alonzi R, Lowe G, Bryant L. Are you the author?
Cancer Centre, Mount Vernon Hospital, Northwood, UK.
Reference: Radiother Oncol. 2014 Jul 10. pii: S0167-8140(14)00255-2.