Treatment results of PDR brachytherapy combined with external beam radiotherapy in 106 patients with intermediate- to high-risk prostate cancer.
OBJECTIVE
To evaluate treatment outcome of pulsed dose-rate brachytherapy (PDR) combined with external-beam radiotherapy (EBRT) for the treatment of prostate cancer.


METHODS
Between 2002 and 2007, 106 patients were treated by EBRT combined with PDR and followed prospectively. Two, 38, and 66 patients were classified as low-, intermediate-, and high-risk disease respectively according to the National Comprehensive Cancer Network criteria. EBRT dose was 46 Gy in 2.0-Gy fractions. PDR dose was increased stepwise from 24.96 to 28.80 Gy. Biochemical disease free survival and overall survival were determined by the Kaplan-Meier method. Cumulative incidence of late gastrointestinal (GI) and genitourinary (GU) toxicity were scored, according to the Common Terminology Criteria for Adverse Events.


RESULTS
The 3- and 5-year biochemical nonevidence of disease (bNED) were 92.8% (95% confidence interval [CI], 87.1-98.5) and 89.5% (95% CI, 85.2-93.8), respectively. Overall survival at 3 and 5 years was 99% (95% CI, 96-100) and 96% (95% CI, 90-100), respectively. The 3- and 5-year Grade 2 GI toxicity was 5.3% (95% CI, 0-10.6) and 12.0% (95% CI, 1.4-22.6), respectively. No Grade 3 or higher GI toxicity was observed. The 3- and 5-year Grade 2 or higher GU toxicity was 18.7% (95% CI, 10.3-27.1) and 26.9% (95% CI, 15.1-38.7), respectively.


CONCLUSIONS
Results on tumor control and late toxicity of EBRT combined with PDR are good and comparable to results obtained with EBRT combined with high-dose-rate brachytherapy for the treatment of prostate cancer.
Department of Radiation Oncology, Academic Medical Center/University of Amsterdam, The Netherlands. b.r.pieters@amc.uva.nl
Bradley R
BR
Pieters
Elisabeth D
ED
Geijsen
Kees
K
Koedooder
Leo E C M
LE
Blank
Elisa
E
Rezaie
Johan N B
JN
van der Grient
Theo M
TM
de Reijke
Caro C E
CC
Koning
D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D018572:Disease-Free Survival; D041981:Gastrointestinal Tract / Q000528:radiation effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000145:classification / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011878:Radiotherapy / Q000379:methods; D012306:Risk; D016896:Treatment Outcome; D014566:Urogenital System / Q000528:radiation effects