Focal high-dose-rate brachytherapy for localized prostate cancer: toxicity and preliminary biochemical results

Autores de IDIVAL

• 

  Pedro José Prada Gómez

  Autor

  pedrojose.prada@scsalud.es

• 

  Javier Tomás Anchuelo Latorre

  Autor

  javiertomas.anchuelo@scsalud.es

• Samuel Ruiz Arrebola

  Autor

  SAMUEL.RUIZ@SCSALUD.ES

Autores ajenos al IDIVAL

• Cardenal J
• García Blanco A
• Andreescu J
• Ferri M
• Diaz de Cerio I
• Sierrasesumaga N
• Vázquez A
• Pacheco M

Abstract

Background This study aimed to evaluate the outcomes and the toxicity of focal high-dose-rate (HDR) brachytherapy in selected localized prostate cancer patients. Methods Fifty patients were treated with focal high-dose-rate brachytherapy between March 2013 and November 2017, representing 5% of the cases treated by our group during this period. Only patients with very limited and localized tumors, according to strict criteria, were selected for the procedure. The prescribed dose for the focal volume was 24Gy. Results The treated volume corresponded to a mean value of 32% of the total prostatic volume. The mean focal D-90 in our series was 23Gy (range 16-26Gy). The mean initial IPSS was 8.2 (range 0-26), at 6 months 7.5 (range 0-23), and at 24 months 6.7 (range 0-18). No acute or late urinary retention was seen. When the ICIQ-SF score was 0 at the end of treatment, it remained nil thereafter at 1 and 2 years for all patients. No intraoperative or perioperative complications occurred. No rectal toxicity was reported after treatment. Of the total patients identified as potent, only three patients had a very slight decrease of the mean IIEF5. The mean initial PSA was 6.9ng/mL (range 1.9-13.4). At the last follow-up visit, the mean PSA was 3ng/ml (range 0.48-8.11). Conclusion HDR focal brachytherapy in selected patients with low intermediate-risk prostate cancer could achieve the same satisfactory results in terms of relapse-free survival as conventional whole prostate brachytherapy with less toxicity.

Keywords

• Focal brachytherapy; High-dose-rate; Prostate cancer; Results; Toxicity