High-dose-rate brachytherapy alone given as two or one fraction to patients for locally advanced prostate cancer: acute toxicity.
BACKGROUND
To evaluate early urinary (GU) and gastrointestinal (GI) adverse events (AEs) after two or one fraction of high-dose rate brachytherapy (HDR-BT) in advanced prostate cancer.


METHODS
165 patients were treated with 2 × 13 Gy (n=115), or a single dose of 19 Gy (n=24) or 20 Gy (n=26) HDR-BT. Early AEs were assessed using the RTOG scoring system and the International Prostate Symptom Score (IPSS).


RESULTS
Week-2 prevalence of severe IPSS symptoms was higher after 20 Gy than after 26 or 19 Gy but by 12 weeks all groups were at pre-treatment levels or less. Grade-3 GU toxicity was observed ≤9% of patients. No Grade 4 GU and no Grade 3 or 4 GI complications were observed. However, there was a significant increase in catheter use in the first 12 weeks after implant after 19 and 20 Gy compared with 2 × 13 Gy.


CONCLUSIONS
Single dose HDR-BT is feasible with acceptable levels of acute complications; tolerance may have been reached with the single 19 Gy schedule.
Cancer Centre, Mount Vernon Hospital, Middlesex, UK.
Peter
P
Hoskin
Cancer Centre, Mount Vernon Hospital, Middlesex, UK. Electronic address: arc03@btconnect.com.
Ana
A
Rojas
Cancer Centre, Mount Vernon Hospital, Middlesex, UK.
Peter
P
Ostler
Cancer Centre, Mount Vernon Hospital, Middlesex, UK.
Robert
R
Hughes
Cancer Centre, Mount Vernon Hospital, Middlesex, UK.
Roberto
R
Alonzi
Cancer Centre, Mount Vernon Hospital, Middlesex, UK.
Gerry
G
Lowe
Cancer Centre, Mount Vernon Hospital, Middlesex, UK.
Linda
L
Bryant
D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods*; D004307:Dose-Response Relationship, Radiation; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D007496:Iridium Radioisotopes / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology*; D012007:Rectum / Q000528:radiation effects; D014521:Urethra / Q000528:radiation effects; D014570:Urologic Diseases / Q000209:etiology
D007496:Iridium Radioisotopes
Early adverse events; High-dose-rate brachytherapy; Large dose per fraction; Monotherapy; Prostate cancer; Single dose