title: Focal brachytherapy for selected low-risk prostate cancers: a pilot study.
abstract: OBJECTIVE
  To evaluate the feasibility and the early toxicity of focal brachytherapy in highly selected localized prostate cancer patients.
  
  
  METHODS
  Twenty-one patients underwent a focal brachytherapy between February 2010 and March 2012, representing 3.7% of the cases treated by our group during this period. Patient selection was based on (at least) two series of prostate biopsies and a high-resolution MRI. Only patients with very limited and localized tumors, according to strict criteria, were selected for the procedure. The technique used a real-time procedure with the implantation of free (125)I seeds and dynamic dose calculation. The prescribed dose for the focal volume was 145Gy.
  
  
  RESULTS
  The treated volume corresponded to a mean value of 34% of the total prostatic volume (range, 20-48%). For the focal volume, the mean D90 and V100 was 183.2Gy (range, 176-188Gy) and 99.3% (range, 98.8-100%), respectively. The technique was performed in an hour and a half. When compared with a previous cohort treated by whole-prostate brachytherapy, urinary toxicity (International Prostate Symptom Score) was borderline reduced (p = 0.04) at 6 months only, whereas the recovery of the International Index of Erectile Function 5 was better (p = 0.014). The International Continence Score was nil in almost all cases as well as rectal toxicity.
  
  
  CONCLUSIONS
  Focal treatment by brachytherapy is easily feasible with little acute toxicity. Further investigation is needed to assess the results in terms of tumor control and long-term toxicity.
authors.affiliation: Department of Oncology/Radiotherapy, Institut Curie, Paris, France. jean-marc.cosset@curie.net
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Cosset
authors.forename: Xavier
authors.initials: X
authors.lastname: Cathelineau
authors.forename: Georges
authors.initials: G
authors.lastname: Wakil
authors.forename: Noelle
authors.initials: N
authors.lastname: Pierrat
authors.forename: Olivier
authors.initials: O
authors.lastname: Quenzer
authors.forename: Dominique
authors.initials: D
authors.lastname: Prapotnich
authors.forename: Eric
authors.initials: E
authors.lastname: Barret
authors.forename: François
authors.initials: F
authors.lastname: Rozet
authors.forename: Marc
authors.initials: M
authors.lastname: Galiano
authors.forename: Guy
authors.initials: G
authors.lastname: Vallancien
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010865:Pilot Projects; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage
chemical_list: D007457:Iodine Radioisotopes; D017430:Prostate-Specific Antigen