title: Toxicity and quality of life after high-dose-rate brachytherapy as monotherapy for low- and intermediate-risk prostate cancer.
abstract: OBJECTIVE
  The use of HDR brachytherapy (HDR-BT) as monotherapy for prostate cancer (PC) is increasing worldwide with good tumour control rates and acceptable toxicity. We report our results on toxicity and quality of life (QoL) after HDR-BT monotherapy for PC patients.
  
  
  METHODS
  166 low- and intermediate-risk localized PC patients were treated with HDR-BT to a total dose of 38Gy in four fractions. Genitourinary (GU) and gastrointestinal (GI) toxicities were prospectively assessed using EORTC-RTOG questionnaires and physicians charts. QoL was evaluated using EORTC QLQ-PR25 questionnaires.
  
  
  RESULTS
  Three months after treatment, acute GU and GI toxicities were reported in 10.8% and 7.2%. Acute toxicity resolved within two months in the majority of patients (61%). Late grade ⩾ 2 GU and GI toxicity were reported in 19.7% and 3.3% of patients 12 months after HDR-BT. Mean QLQ-PR25 scores showed clinically relevant changes from baseline for urinary symptoms and sexual functioning. With a mean follow-up of 35 months, biochemical failure was observed in 2.4%. Overall survival at 60 months was 93.6% and cancer-specific survival was 100%.
  
  
  CONCLUSIONS
  HDR-BT monotherapy for localized PC showed excellent clinical outcome and acceptable acute and late toxicity. Urinary symptoms and sexual function QoL decreased after treatment.
authors.affiliation: Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands. Electronic address: s.aluwini@erasmusmc.nl.
authors.forename: Shafak
authors.initials: S
authors.lastname: Aluwini
authors.affiliation: Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors.forename: Wendy M H
authors.initials: WM
authors.lastname: Busser
authors.affiliation: Clinical Trial Center, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors.forename: Wendimagegn Ghidey
authors.initials: WG
authors.lastname: Alemayehu
authors.affiliation: Department of Urology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors.forename: Joost L
authors.initials: JL
authors.lastname: Boormans
authors.affiliation: Department of Urology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors.forename: Wim J
authors.initials: WJ
authors.lastname: Kirkels
authors.affiliation: Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Jansen
authors.affiliation: Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors.forename: John O
authors.initials: JO
authors.lastname: Praag
authors.affiliation: Department of Urology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors.forename: Chris H
authors.initials: CH
authors.lastname: Bangma
authors.affiliation: Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors.forename: Inger-Karine K
authors.initials: IK
authors.lastname: Kolkman-Deurloo
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D007610:Kallikreins / Q000097:blood; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000534:rehabilitation; D011788:Quality of Life; D011832:Radiation Injuries / Q000209:etiology; D011879:Radiotherapy Dosage; D016896:Treatment Outcome; D016055:Urinary Retention / Q000209:etiology
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen
keywords: Clinical outcome; HDR-brachytherapy; Prostate cancer; Quality of life; Radiotherapy; Toxicity