title: External beam radiotherapy plus high-dose-rate brachytherapy for treatment of locally advanced prostate cancer: the initial experience of the Catalan Institute of Oncology.
abstract: OBJECTIVE
  The objective of this study was to report initial outcomes in patients with locally advanced prostate cancer (CaP) who underwent external beam radiation therapy (EBRT) treatment combined with high-dose-rate brachytherapy (HDR-BT) as a boost.
  
  
  METHODS
  From 2002 to 2007, 114 CaP patients underwent EBRT followed by (192)I HDR-BT. The patients were classified into intermediate- (Group 1) or high- (Group 2) risk groups. The mean total EBRT dose was 60.0Gy (95% confidence interval [CI]: 59.9-60.1) at 2Gy per fraction. After a mean of 20.6 days (95% CI: 18.4-22.8), all the patients received a single-fraction 9-Gy dose of HDR-BT boost. Of the 114 patients in the study, 103 (90.4%) underwent up to 3 years of complete androgen deprivation therapy after diagnosis.
  
  
  RESULTS
  The mean followup for the entire group was 32.1 months (95% CI: 29.9-34.4). The 4-year biochemical failure-free survival rate was 97.4% and treatment was well-tolerated.
  
  
  CONCLUSIONS
  Preliminary biochemical control rates after EBRT plus one fraction of 9-Gy HDR-BT are encouraging. This atypical fractionation schedule is cost-effective and reduces patient discomfort and treatment-related risks. More followup is required to confirm these findings.
authors.affiliation: Department of Radiation Oncology, Regional Centre of Radiotherapy and Nuclear Medicine, Cagliari, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Pistis
authors.forename: Ferran
authors.initials: F
authors.lastname: Guedea
authors.forename: Joan
authors.initials: J
authors.lastname: Pera
authors.forename: Cristina
authors.initials: C
authors.lastname: Gutierrez
authors.forename: Montse
authors.initials: M
authors.lastname: Ventura
authors.forename: Alfredo
authors.initials: A
authors.lastname: Polo
authors.forename: Evelyn
authors.initials: E
authors.lastname: Martinez
authors.forename: Ana
authors.initials: A
authors.lastname: Boladeras
authors.forename: Ferran
authors.initials: F
authors.lastname: Ferrer
authors.forename: Pietro
authors.initials: P
authors.lastname: Gabriele
authors.forename: Luis
authors.initials: L
authors.lastname: Linares
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000706:statistics & numerical data*; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000706:statistics & numerical data*; D013030:Spain / Q000453:epidemiology; D016896:Treatment Outcome