title: A Report on the Clinical Outcome after High-Dose Rate (HDR) Brachytherapy as Monotherapy in Early Prostate Cancer.
abstract: BACKGROUND
  To report the clinical outcome after a single implant, high dose rate (HDR) brachytherapy in early prostate cancer.
  
  
  METHODS
  All clinically localized prostate cancer patients who underwent high-dose rate (HDR) brachytherapy as monotherapy (no external beam radiotherapy) from February 2006 to September 2011 were analyzed prospectively. Acute and chronic toxicity were assessed as per Common Terminology Criteria for Adverse Events (CTCAE), Version 4.03. Biochemical recurrence was analyzed using the Kaplan Meir method. A log-rank analysis was done to compare the factors affecting the outcome.
  
  
  RESULTS
  Forty-four patients with organ-confined prostate cancer opted for HDR brachytherapy between February 2006 to September 2011 with a median follow-up of 68 months  The five-year biochemical recurrence-free survival (bRFS) rate was 91%. Late Grade 2 genitourinary (GU) toxicity was observed in 9% of patients. The predictors of late Grade 2 GU toxicity were urethra V125 ≥ 0.2 cc (urethral volume receiving ≥ 125% of the prescribed dose) and PTV 150 ≥ 35% ( planning target volume receiving ≥ 150% of the prescribed dose) with p-value = 0.001 and 0.002, respectively. Erectile function was preserved in 72% of the patients who had Grade 0-1 erectile dysfunction before brachytherapy.
  
  
  CONCLUSIONS
  HDR brachytherapy in early prostate cancer results in high local control rates with minimal side-effects.
authors.affiliation: Department of Radiation Oncology, Apollo Hospitals.
authors.forename: Mahadev
authors.initials: M
authors.lastname: Potharaju
authors.affiliation: Department of Uro-Oncology, Apollo Hospitals.
authors.forename: Ravishankar
authors.initials: R
authors.lastname: Subramanaiam
authors.affiliation: Medical Physics, Apollo Hospitals.
authors.forename: Murali
authors.initials: M
authors.lastname: Venkataraman
authors.affiliation: Department of Radiation Oncology, Apollo Hospitals.
authors.forename: Karthikeyan
authors.initials: K
authors.lastname: Perumal
authors.affiliation: Biostatistics, Apollo Hospitals.
authors.forename: Balasubramaniam
authors.initials: B
authors.lastname: Ramakrishnan
authors.affiliation: Department of Radiation Oncology, Apollo Hospitals.
authors.forename: Ramakrishna
authors.initials: R
authors.lastname: Vangara
authors.affiliation: Department of Radiation Oncology, Apollo Hospitals.
authors.forename: Sathiya
authors.initials: S
authors.lastname: Reddy
keywords: high-dose rate brachytherapy; hypofractionation; ipss; organ-confined prostate cancer