High-dose-rate brachytherapy without external beam irradiation for locally advanced prostate cancer.
OBJECTIVE
High-dose-rate brachytherapy (HDR-BT) had been used only in combination with external beam irradiation (EBI) until our previously reported first trial of HDR-BT alone without EBI. The purpose of the current report is to evaluate the feasibility, toxicity and efficacy of this regimen, with more patient accrual and longer follow-up.


METHODS
From 1995 through 2004, 111 patients with localized prostate cancer were treated with HDR-BT without EBI. Fifteen patients were considered as low-risk, 28 as intermediate-risk, and 68 as high-risk. The prescribed dose was 48 Gy/8 fractions/5 days or 54 Gy/9 fractions/5 days. Median follow-up time was 27 months (range 5-119).


RESULTS
All the patients completed the treatment regimen. The 3- and 5-year PSA failure-free rates were 83% and 70%, and the local control rates 100% and 97%. The maximum toxicities observed were Grade 3 by CTCAE v3.0 (6 acute, 1 chronic).


CONCLUSIONS
HDR-BT without EBI was feasible and its toxicity acceptable. Short-term tumor control was promising, even for locally advanced cases. More patient accrual and longer follow-up are needed to confirm the efficacy of this novel approach.
Yoshioka
Yasuo
Y
Department of Radiation Oncology, Osaka University Graduate Schoolf of Medicine, Japan. yoshioka@radonc.med.osaka-u.ac.jp
Konishi
Koji
K
Oh
Ryoong-Jin
RJ
Sumida
Iori
I
Yamazaki
Hideya
H
Nakamura
Satoaki
S
Nishimura
Kazuo
K
Nonomura
Norio
N
Okuyama
Akihiko
A
Inoue
Takehiro
T
D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000096:biosynthesis; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011874:Radiometry; D011878:Radiotherapy / Q000379:methods*; D012306:Risk; D013997:Time Factors; D016896:Treatment Outcome
D017430:Prostate-Specific Antigen