To evaluate the oncological outcome of a three-implant high dose rate (HDR) brachytherapy (BRT) protocol as monotherapy for clinically localised prostate cancer.
Between February 2008 and December 2012, 450 consecutive patients with clinically localised prostate cancer were treated with HDR monotherapy. The cohort comprised of 198 low-, 135 intermediate- and 117 high risk patients being treated with three single-fraction implants of 11.5Gy delivered to an intraoperative real-time, transrectal ultrasound defined planning treatment volume up to a total physical dose of 34.5Gy with an interfractional interval of 21days. Fifty-eight patients (12.8%) received ADT, 32 of whom were high- and 26 intermediate-risk. Biochemical failure was defined according to the Phoenix Consensus Criteria and genitourinary/gastrointestinal toxicity evaluated using the Common Toxicity Criteria for Adverse Events version 3.0.
The median follow-up time was 56.3months. The 60-month overall survival, biochemical control and metastasis-free-survival rates were 96.2%, 95.0% and 99.0%, respectively. Toxicity was scored per event with late Grade 2 and 3 genitourinary adverse events of 14.2% and 0.8%, respectively. Late Grade 2 gastrointestinal toxicity amounted 0.4% with no instances of Grade 3 or greater late adverse events to be reported.
Our results confirm HDR BRT to be a safe and effective monotherapeutic treatment modality for clinically localised prostate cancer.
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2017 Oct 23 [Epub ahead of print]
Iosif Strouthos, Nikolaos Tselis, Georgios Chatzikonstantinou, Saeed Butt, Dimos Baltas, Dimitra Bon, Natasa Milickovic, Nikolaos Zamboglou
Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany. Electronic address: ., Department of Radiotherapy and Oncology, J. W. Goethe University of Frankfurt, Frankfurt am Main, Germany., Division of Medical Physics, Department of Radiation Oncology, Sana Klinikum Offenbach, Offenbach, Germany., Division of Medical Physics, Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany; German Cancer Consortium (DKTK), Partner Site Freiburg, Germany., Institute for Biostatistics and Mathematical Modeling, J. W. Goethe University of Frankfurt, Frankfurt am Main, Germany.