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Long-term outcome of high dose rate brachytherapy in radiotherapy of localised prostate cancer.

Journal article
Authors Lennart Åström
Dorte Pedersen
Claes Mercke
Sten Holmäng
Karl-Axel Johansson
Published in Radiother Oncol
Volume 74
Issue 2
Pages 157-161
Publication year 2005
Published at Institute of Selected Clinical Sciences, Department of Oncology
Institute of Selected Clinical Sciences, Department of Radiation Physics
Institute of Surgical Sciences, Department of Urology
Pages 157-161
Language en
Links dx.doi.org/10.1016/j.radonc.2004.10...
Keywords Prostate cancer; Radiotherapy; Brachytherapy; High dose rate
Subject categories Urology and andrology

Abstract

Background and purpose High dose rate brachytherapy (HDR-BT) in prostate cancer (PC) is receiving increasing interest. The steep dose gradient gives a possibility to escalate the dose to the prostate. If the α/β ratio is low for PC, hypofractionation will be of advantage. A retrospective analysis of outcome in patients (pts) consecutively treated with combined HDR-BT and conformal external beam radiotherapy (ERT) was performed. Material and methods Data from 214 pts treated consecutively from 1988 to 2000 were analysed. The median age was 64 years (50–77). Median follow up was 4 years (12–165 months). Pre-irradiatory endocrine therapy was given to 150 pts (70%). The pts were divided into low-, intermediate- and high (80/87/47 pts) risk groups according to the occurrence of none, one, or more risk factors defined by T-classification, PSA and histopathology. ERT was given with 2 Gy fractions to 50 Gy. HDR-BT consisted of two 10 Gy fractions. Results Overall 5-year biochemical no evidence of disease (bNED) was 82%, and for the low-, intermediate-, and high-risk group bNED was 92, 88 and 61%, respectively. PSA-relapse was found in 17, local recurrence in 3 and distant metastases in 13 pts. Five pts died of PC. No recurrences were observed after 5 years. Severe late complications were few. Urethral stricture (13 pts) was the most frequent. No severe rectal complications were seen. Conclusion Dose escalation with HDR-BT is safe and effective in radiotherapy of localised PC.

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