High dose rate and external beam radiotherapy in locally advanced prostate cancer.
OBJECTIVE
To report the outcomes and toxicity of high dose rate brachytherapy as a boost for localized prostate cancer.


METHODS
Between 1997 and 2000, the medical records of 131 patients with prostate adenocarcinoma who were treated with external beam radiation therapy and high dose rate brachytherapy, were retrospectively analyzed. Furthermore, 55% of the patients received neoadjuvant/concurrent or adjuvant androgen deprivation therapy. Patients were stratified into 2 groups. Group 1 included 65 patients with Gleason score 7, pretreatment prostate specific antigen (PSA) between 10 and 20 ng/mL, and clinical stage T2b. Group 2 included 66 patients with Gleason score between 8 and 10, PSA greater than 20 ng/mL, and clinical stage greater than T2b.


RESULTS
At a median follow-up of 62.8 months, the 5-year biochemical control (BC) rate, as defined by the American Society for Therapeutic Radiology and Oncology Phoenix Consensus panel statement, was 81% and overall survival was 91%. BC in Groups 1 and 2 were 87% and 71%, respectively. On univariate analysis risk group, pretreatment PSA and age were significant predictors of BC. However, on multivariate analysis only pretreatment PSA was significant. Using the Radiation therapist oncology group criteria, there were 2 (1.5%) cases of grade 3 acute urinary toxicity. Regarding late side effects (n = 5), 4% of patients had grade 3 genitourinary toxicity and no grade 4 complication was observed.


CONCLUSIONS
External beam radiation therapy and high dose rate brachytherapy for prostate cancer resulted in excellent BC, and overall survival with minimal severe, acute, or late complications.
Viani
Gustavo Arruda
GA
Radiation Oncology Department, Hospital do Cancer, São Paulo, Brazil. gusviani@gmail.com
Pellizzon
Antonio Cássio
AC
Guimarães
Flavio Silva
FS
Jacinto
Alexandre Arthur
AA
dos Santos Novaes
Paulo Eduardo Ribeiro
PE
Salvajoli
João Vitor
JV
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use; D001918:Brachytherapy; D004307:Dose-Response Relationship, Radiation; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D012189:Retrospective Studies
D000726:Androgen Antagonists