Single-dose high-dose-rate brachytherapy compared to two and three fractions for locally advanced prostate cancer

Peter Hoskin, Ana Rojas, Peter Ostler, Robert Hughes, Roberto Alonzi, Gerry Lowe

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Single-dose high-dose-rate brachytherapy (HDR-BT), in a Phase-II study, was compared to two or three fractions in intermediate and high-risk localized prostate cancer.

PATIENTS AND METHODS: 293 patients received 1×19Gy or 1×20Gy (A=49), 2×13Gy (B=138), or 3×10.5Gy (C=106) and assessed with prospective measures of serum PSA, late genitourinary (GU) and gastrointestinal (GI) morbidity using RTOG scales and the International Prostate Symptom Score (IPSS).

RESULTS: Median follow-up is 49, 63 and 108months (A, B and C, respectively). At 4years biochemical relapse free survival was 94% (A), 93% (B) and 91% (C) (p=0.54). Risk-category was the only significant independent predictor of relapse (p<0.0001). Kaplan-Meier 4-year-estimates of GU-3 were 2% (A and B) and 11% (C). GI-3 was 0% (A and B) and 1% (C). No GU or GI grade-4 events were observed. IPSS≥20 was 11% (A), 9% (B) and 16% (C) (p=0.9). Prevalence of GU-3 was ≤4% in the 3 groups at all times; GI-3 was low or non-existent. Prevalence of catheter use was ≤6% in all groups.

CONCLUSIONS: A single dose of 19-20Gy achieves similar rates of late morbidity and biochemical control compared to 2 and 3 fractions.

Original languageEnglish
Pages (from-to)56-60
Number of pages5
JournalRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Volume124
Issue number1
DOIs
Publication statusPublished - Jul 2017

Keywords

  • Aged
  • Aged, 80 and over
  • Brachytherapy/adverse effects
  • Humans
  • Kallikreins/blood
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local/blood
  • Prospective Studies
  • Prostate-Specific Antigen/blood
  • Prostatic Neoplasms/blood

Research Beacons, Institutes and Platforms

  • Manchester Cancer Research Centre

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