title: Randomised trial of external beam radiotherapy alone or combined with high-dose-rate brachytherapy boost for localised prostate cancer.
abstract: BACKGROUND
  A randomised phase-III trial compared external beam radiotherapy (EBRT) alone with EBRT combined with high-dose-rate brachytherapy boost (HDR-BTb) in localised prostate adenocarcinoma.
  
  
  METHODS
  From December 1997 to August 2005, 218 patients were assigned to EBRT alone (n=108) or EBRT followed by a temporary high-dose-rate implant (n=110). Patients were stratified according to tumour stage, PSA, Gleason score and androgen deprivation therapy (ADT). Biochemical/clinical relapse-free survival (RFS) was the primary endpoint. Secondary endpoints were overall survival (OS), urinary and bowel toxicity.
  
  
  RESULTS
  RFS was significantly higher in patients treated with EBRT+HDR-BTb (log rank p=0.04). In multivariate analysis treatment arm, risk category and ADT were significant covariates for risk of relapse. Differences in OS were not significant. Incidence of severe late urinary and bowel morbidity was similar.
  
  
  CONCLUSIONS
  EBRT+HDR-BTb resulted in a significant improvement in RFS compared to EBRT alone with a 31% reduction in the risk of recurrence (p=0.01) and similar incidence of severe late urinary and rectal morbidity.
authors.affiliation: Cancer Centre, Mount Vernon Hospital, Northwood, UK.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Hoskin
authors.forename: Ana M
authors.initials: AM
authors.lastname: Rojas
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Bownes
authors.forename: Gerry J
authors.initials: GJ
authors.lastname: Lowe
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Ostler
authors.forename: Linda
authors.initials: L
authors.lastname: Bryant
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000401:mortality / Q000532:radiotherapy*