title: [Clinical outcome in prostate cancer patients undergoing high-dose-rate brachytherapy with external beam radiotherapy in our institute].
abstract: OBJECTIVE
  We investigate the biochemical control rates and adverse events for local and locally advanced prostate cancer patients undergoing high-dose-rate brachytherapy with external beam radiotherapy (EBRT + HDR-BT) in our institute.
  
  
  METHODS
  From May 2004 through March 2010, 154 patients with local and locally advanced prostate cancer underwent EBRT + HDR-BT. One hundred thirteen patients with more than 6 months follow-up were evaluated. A median follow-up was 33 months. The patients consisted of 12 low-, 65 intermediate- and 36 high-risk patients. No patients received adjuvant androgen deprivation therapy with EBRT + HDR-BT. Biochemical freedom from failure (bFFF) was determined using the Phoenix definition.
  
  
  RESULTS
  The 5-year bFFF rate was 100%, 94.7%, and 59.2% for low-, intermediate- and high-risk patients. The 58-month bFFF rate of high-risk patients with one ominous factor was significantly lower than that of high-risk patients with more than ominous two factors (87.4% vs 26.9%, p = 0.022). With respect to acute adverse events, transurethral electric coagulation was performed for vesical bleeding and tamponade after removal of applicator needles in only one patient. Regarding late adverse events 14.2% of patients had grade 3 genitourinary toxicity, mostly consisted of urethral stricture and 0.9% of patients had grade 3 gastrointestinal toxicity.
  
  
  CONCLUSIONS
  EBRT + HDR-BT without adjuvant androgen deprivation therapy yields excellent bFFF in low- and intermediate-risk prostate cancer patients. However, to challenge higher bFFF rate in a part of high-risk patients and lower rate of adverse events, modified designing protocols and therapeutic plannning of EBRT + HDR-BT may be necessary.
authors.affiliation: Department of Urology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
authors.forename: Naotaka
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Masakazu
authors.initials: M
authors.lastname: Akitake
authors.forename: Saya
authors.initials: S
authors.lastname: Ikoma
authors.forename: Ken
authors.initials: K
authors.lastname: Ri
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Masuda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshikawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Iguchi
authors.forename: Kazushige
authors.initials: K
authors.lastname: Atsumi
authors.forename: Taisei
authors.initials: T
authors.lastname: Matsumura
authors.forename: Satoru
authors.initials: S
authors.lastname: Uehara
mesh_terms: D000368:Aged; D001918:Brachytherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D016896:Treatment Outcome