title: High-dose-rate brachytherapy with two or three fractions as monotherapy in the treatment of locally advanced prostate cancer.
abstract: BACKGROUND
  To evaluate late urinary (GU) and gastrointestinal (GI) adverse events (AEs) and biochemical control of disease after high-dose rate brachytherapy (HDR-BT) in locally advanced prostate cancer.
  
  
  METHODS
  227 consecutive patients were treated with 3 × 10.5 Gy (n = 109) or 2 × 13 Gy (n = 118) HDR-BT alone. Biochemical failure was assessed using the Phoenix definition of PSA nadir + 2 μg/l and late AEs using the RTOG scoring system and the International Prostate Symptom Score (IPSS).
  
  
  RESULTS
  Kaplan-Meier estimates and prevalence of late events indicate that urinary, bowel and IPSS symptoms are higher after 31.5 Gy than after 26 Gy, however differences are significant only for Grade 1 and 2 urinary toxicity. Kaplan-Meier estimates of morbidity are consistently and considerably higher than time-point estimates of prevalence; which reflects the transient nature of most symptoms. At 3 years 93% and 97% of patients treated with 26 and 31.5 Gy, respectively, were free from biochemical relapse (p = 0.5) and 91% for the latter regimen at 5 years. In univariate and multivariate analysis risk-category was the only significant predictor of relapse (p < 0.03).
  
  
  CONCLUSIONS
  These HDR-BT schedules achieved high levels of biochemical control of disease in patients with advanced prostate cancer with few severe complications seen throughout the first 3 years.
authors.affiliation: Cancer Centre, Mount Vernon Hospital, Northwood, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Hoskin
authors.affiliation: Cancer Centre, Mount Vernon Hospital, Northwood, UK. Electronic address: arc03@btconnect.com.
authors.forename: Ana
authors.initials: A
authors.lastname: Rojas
authors.affiliation: Cancer Centre, Mount Vernon Hospital, Northwood, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Ostler
authors.affiliation: Cancer Centre, Mount Vernon Hospital, Northwood, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Hughes
authors.affiliation: Cancer Centre, Mount Vernon Hospital, Northwood, UK.
authors.forename: Roberto
authors.initials: R
authors.lastname: Alonzi
authors.affiliation: Cancer Centre, Mount Vernon Hospital, Northwood, UK.
authors.forename: Gerry
authors.initials: G
authors.lastname: Lowe
authors.affiliation: Cancer Centre, Mount Vernon Hospital, Northwood, UK.
authors.forename: Linda
authors.initials: L
authors.lastname: Bryant
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology / Q000532:radiotherapy*; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D019583:Dose Fractionation, Radiation; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D007610:Kallikreins / Q000097:blood; D008297:Male; D052801:Male Urogenital Diseases / Q000209:etiology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology; D011879:Radiotherapy Dosage; D016896:Treatment Outcome
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: Biochemical relapse; High-dose-rate brachytherapy; Late adverse events; Monotherapy; Prostate cancer