title: High-dose rate brachytherapy in localized penile cancer: short-term clinical outcome analysis.
abstract: OBJECTIVE
  To assess clinical outcomes of high-dose rate interstitial brachytherapy (HIB) in localized penile carcinoma.
  
  
  METHODS
  From 03/2006 to 08/2013, patients with biopsy-proven T1-T2 (<4 cm) non-metastatic localized penile squamous cell carcinoma underwent HIB. Under general anaesthesia, after Foley catheter placement, needles were placed in the target volume using a dedicated template. Planification was carried out with a post-implant CT-scan to deliver a total dose of 36 Gy in 9 fractions over 5 days (in adjuvant setting) or 39 Gy in 9 fractions over 5 days (as monotherapy). Dose-volume adaptation was manually achieved using graphical optimization. Dosimetric data and clinical outcomes were retrospectively analyzed. Toxicities were graded using the CTC v4.0.
  
  
  RESULTS
  With a median follow-up of 27 months [5.1-83], 12 patients including 8 T1a, 3 T1b and 1 T2 N0 underwent HIB (sole therapy: 11 pts; adjuvant: 1 pt). The actuarial 5-year relapse-free, cause-specific and overall survival rates were 83%, 100% and 78% respectively. Comparing pre and post treatment evaluation, no IPSS or IIEF-5 changes were reported. Dermatitis was reported systematically 1 month after HIB including 6 G1, 5 G2 and 1 G3. Only 1 experienced long-term G3 successfully treated with hyperbaric oxygen therapy. One urethral meatus stenosis G3 required meatotomy.
  
  
  CONCLUSIONS
  In selected patients with T1-T2 localized penile cancer, HIB may be considered as an optional conservative therapy. Longer follow-up is needed to confirm these encouraging preliminary results.
authors.forename: Yohann
authors.initials: Y
authors.lastname: Rouscoff
authors.forename: Alexander Tuan
authors.initials: AT
authors.lastname: Falk
authors.forename: Matthieu
authors.initials: M
authors.lastname: Durand
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Gal
authors.forename: Marie-Eve
authors.initials: ME
authors.lastname: Chand
authors.forename: Mathieu
authors.initials: M
authors.lastname: Gautier
authors.forename: Alexandre
authors.initials: A
authors.lastname: Marsaud
authors.forename: Daniel
authors.initials: D
authors.lastname: Chevallier
authors.forename: Jean
authors.initials: J
authors.lastname: Amiel
authors.affiliation: Department of Radiation Therapy, Antoine Lacassagne Cancer Center and University of Nice-Sophia, Nice, France. jean-michel.hannoun-levi@nice.unicancer.fr.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Hannoun-Levi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D010412:Penile Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies