title: Prostate high dose rate brachytherapy in a free-standing cancer center setting.
abstract: OBJECTIVE
  To determine the safety and acute tolerance of performing prostate high dose rate (HDR) brachytherapy in a free-standing cancer center setting, and to report our approach in delivering such treatment.
  
  
  METHODS
  Patients treated with prostate HDR from the inception of our program through December 2004 were included. Disease- and treatment-related information was gathered from chart review. Acute side effects were obtained from both chart review and questioning the patient at follow-up visits.
  
  
  RESULTS
  A total of 234 patients were treated with 459 HDR needle insertions. Nearly all patients were treated with external beam irradiation, and the majority also received adjuvant hormonal manipulation. There were no adverse events related to transport to the free-standing cancer center. Treatment was well tolerated, with only 3.7% of procedures developing retention requiring catheter placement; 20% of patients reported significant postimplant dysuria, mean duration of any dysuria being 7.5 days. Postimplant retention and length of any dysuria were not found to be related to any of the analyzed factors. Severity of dysuria was found to be related only to timing of external beam. Postimplant retention was more frequent for some physicians, but this finding was not statistically significant.
  
  
  CONCLUSIONS
  Prostate HDR brachytherapy can be delivered safely and effectively in an ambulatory free-standing cancer center setting when done by a urology and radiation oncology team working in close conjunction. Treatment combining HDR brachytherapy as described with external beam radiation, with or without androgen manipulation, is well tolerated by the patient.
authors.affiliation: Radiation Oncology, Central Indiana Cancer Centers, Indianapolis, IN 46227, USA. Morgan.Tharp@usoncology.com
authors.forename: Morgan
authors.initials: M
authors.lastname: Tharp
authors.forename: Richard
authors.initials: R
authors.lastname: Bennett
authors.forename: Jennifer
authors.initials: J
authors.lastname: Burns
authors.forename: W Terry
authors.initials: WT
authors.lastname: Jones
authors.forename: David
authors.initials: D
authors.lastname: Scheidler
authors.forename: Philip
authors.initials: P
authors.lastname: Serbin
authors.forename: David
authors.initials: D
authors.lastname: Stuhldreher
authors.forename: Jeff
authors.initials: J
authors.lastname: Vaught
authors.forename: Yun
authors.initials: Y
authors.lastname: Wang
mesh_terms: D001918:Brachytherapy / Q000379:methods*; D053159:Dysuria / Q000209:etiology; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D012189:Retrospective Studies; D012449:Safety; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome