Long-term oncological outcomes and toxicity in 597 men ≤60 years of age at time of low dose rate brachytherapy for localised prostate cancer.

To report oncological and functional outcomes of men treated with low dose rate (LDR) prostate brachytherapy who were 60 years old or younger at time of treatment.

Of 3,262 patients treated with LDR brachytherapy at our centre up to June 2016, we retrospectively identified 597 patients ≤60 years at treatment with at least three years post-implant follow-up and four PSA measurements of which one was the baseline. Overall disease-specific and relapse-free survival were analysed together with prospectively collected physician reported adverse events and patient reported symptom scores.

Median (range) age was 57 (44-60) years, median follow-up 8.9 (1.5-17.2) years and median PSA follow-up 5.9 (0.8-15) years. Low, intermediate and high-risk disease represented 53%, 37% and 10% of cases. Ten years post-implant overall and prostate cancer-specific survival were 98% and 99% for low-risk, 99% and 100% for intermediate and 93% and 95% for high-risk disease respectively. Ten years post-implant relapse free survival using the nadir plus 2 definition was 95%, 90% and 87% for low, intermediate and high-risk disease respectively. Urinary stricture was the most common genitourinary event observed in 19 (3.2%) patients. Preserved erectile function five years post-implant was observed in 75% of patients who were potent prior to treatment.

LDR brachytherapy is an efficacious treatment with long-term control of prostate cancer in men ≤60 years at time of treatment. It was associated with low rates of treatment related toxicity and can be considered a first line treatment for prostate cancer in this patient group. This article is protected by copyright. All rights reserved.

BJU international. 2017 Jul 03 [Epub ahead of print]

Stephen E M Langley, Ricardo Soares, Jennifer Uribe, Santiago Uribe-Lewis, Julian Money-Kyrle, Carla Perna, Sara Khaksar, Robert Laing

St Luke's Cancer Centre, Guildford, United Kingdom.