title: Results of high dose-rate brachytherapy boost before 2D or 3D external beam irradiation for prostate cancer.
abstract: OBJECTIVE
  To evaluate biochemical control and treatment related toxicity of patients with localized adenocarcinoma of the prostate treated with high dose-rate brachytherapy (HDRB) combined with conventional 2D or 3D-conformal external beam irradiation (EBI).
  
  
  METHODS
  Four-hundred and three patients treated between December 2000 and March 2004. HDRB was delivered with three fractions of 5.5-7 Gy with a single implant, followed by 45 Gy delivered with 2D or 3D conformal EBI.
  
  
  RESULTS
  The median follow-up was 48.4 months. Biochemical failure (BF) occurred in 9.6% according to both ASTRO and Phoenix consensus criteria. Mean time to relapse was 13 and 26 months, respectively. The 5-year BF free survival using the ASTRO criteria was 94.3%, 86.9% and 86.6% for the low, intermediate and high risk groups, respectively; using Phoenix criteria, 92.4%, 88.0% and 85.3%, respectively. The only predictive factor of BF in the multivariate analysis by both ASTRO and Phoenix criteria was the presence of prostate nodules detected by digital palpation, and patients younger than 60 years presented a higher chance of failure using Phoenix criteria only.
  
  
  CONCLUSIONS
  Treatment scheme is feasible and safe with good efficacy.
authors.affiliation: Institute of Cancer Arnaldo Vieira de Carvalho, University of São Paulo, Brazil.
authors.forename: Cristiano Beck
authors.initials: CB
authors.lastname: Neviani
authors.forename: Miguel Abrão
authors.initials: MA
authors.lastname: Miziara
authors.forename: Heloisa
authors.initials: H
authors.lastname: de Andrade Carvalho
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects; D007172:Erectile Dysfunction / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen