Low-dose rate brachytherapy with I-125 seeds has an excellent 5-year outcome with few side effects in patients with low-risk prostate cancer

Low-dose rate brachytherapy (LDR-BT) has been used in Sweden for more than a decade for treatment of low-risk prostate cancer. This study presents the outcome for patients treated with LDR-BT at a single institution with focus on the association between dose and biochemical failure-free survival (BFFS).

In total 195 patients were treated with LDR-BT between 2004 and 2008. The patients were followed systematically for side effects for at least one year. PSA levels were followed regularly from three months and for at least five years. Outcome was analyzed in relation to clinical variables at baseline and to radiotherapy data.

Kaplan-Meier estimated BFFS at five years was 95.7%. Dose to the prostate in terms of D90% was significantly associated with BFFS [HR 0.90 (95%CI 0.83-0.96), p = 0.002].

Out data confirmed that absorbed dose is a predictive factor for BFFS for low-risk patients without androgen deprivation therapy. With our treatment routines and dosimetry, a D90% in the range of 170-180 Gy gives excellent outcomes with acceptable toxicity for patients with low-risk prostate cancer.

Acta oncologica (Stockholm, Sweden). 2016 May 13 [Epub ahead of print]

Elisabeth Rasmusson, Adalsteinn Gunnlaugsson, Elisabeth Kjellén, Per Nilsson, Margret Einarsdottir, Elinore Wieslander, Per Fransson, Göran Ahlgen, René Blom

a Department of Oncology and Radiation Physics , Skåne University Hospital, Lund University , Lund , Sweden ;, a Department of Oncology and Radiation Physics , Skåne University Hospital, Lund University , Lund , Sweden ;, a Department of Oncology and Radiation Physics , Skåne University Hospital, Lund University , Lund , Sweden ;, a Department of Oncology and Radiation Physics , Skåne University Hospital, Lund University , Lund , Sweden ;, a Department of Oncology and Radiation Physics , Skåne University Hospital, Lund University , Lund , Sweden ;, a Department of Oncology and Radiation Physics , Skåne University Hospital, Lund University , Lund , Sweden ;, b Department of Nursing , Umeå University , Umeå , Sweden ;, c Department of Surgery and Urology , Skåne University Hospital , Malmö , Sweden., a Department of Oncology and Radiation Physics , Skåne University Hospital, Lund University , Lund , Sweden ;