High-dose-rate brachytherapy with two or three fractions as monotherapy in the treatment of locally advanced prostate cancer - Abstract

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.

Written by:
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.
doi: 10.1016/j.radonc.2014.06.007

PubMed Abstract
PMID: 25018002

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