High-dose rate brachytherapy of prostatic adenocarcinoma in combination with external beam radiotherapy a long-term follow-up of the first 50 patients at one center.
OBJECTIVE
To report the long-term follow-up of 50 patients with prostatic adenocarcinoma (PAC) treated by high-dose rate brachytherapy in combination with external beam radiotherapy.


METHODS
Between 1988 and 1995, 50 patients were treated with external beam radiotherapy delivered in 2 Gy fractions to a total dose of 50 Gy. Brachytherapy was delivered in two 10 Gy fractions. The mean follow-up time was 7.2 years.


RESULTS
42 patients are alive and four patients have deceased of prostatic adenocarcinoma. Of the remaining patients, 40 have a PSA < 1 ng/l. 41 patients were interviewed during the year 2000 and 91% of these were satisfied with the treatment. Four (8%) patients reported grade III/IV side effects. Ten of the 41 patients reported that they still had an erection allowing intercourse. Half of those who developed an erectile dysfunction did so in direct connection with the treatment. In the others erectile dysfunction developed gradually during the first 48 months after the treatment.


CONCLUSIONS
The combined treatment gave an exceptionally good local control (86%). The method represents a promising curative treatment, but the effect can be double edged. The small number of patients in this study restricts a more conclusive statement concerning this treatment modality.
Lennernäs
Bo
B
Department of Oncology, Sahlgrenska University Hospital, Sweden. bo.lennernas@telia.com
Holmäng
Sten
S
Hedelin
Hans
H
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D000368:Aged; D001918:Brachytherapy / Q000295:instrumentation; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010410:Penile Erection / Q000528:radiation effects; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology; D011879:Radiotherapy Dosage; D015996:Survival Rate