Brachytherapy for Localized Prostate Cancer: Results in Local Control and Toxicity

Abstract

PurposeLow dose rate (LDR) Brachytherapy is used as a valid option in the treatment of localized prostate cancer. Our objective is to analyze local control and toxicity in patients treated with Brachytherapy in our center.Material and Methods100 patients treated for prostate cancer (low and intermediate risk) with LDR brachytherapy monotherapy from 2009 to 2014. Implants permanent I-125 seeds were used. Technical data: Device First System (seed-Selectron Nucletron) with perineal guided insertion by transrectal ultrasound. Intraoperative planning technique. PSA levels and toxicity through quality test QLQ-PR25 life were monitored and validated by the EORTC (European Organization for Research and Treatment of Cancer).ResultsAfter 24 months follow up, biochemical recurrence free survival was 96%. Four patients had biochemical recurrence: A patient with bone metastases confirmed by PET and two local relapses confirmed by biopsy. Regarding toxicity, when symptoms were compared pre and post implant no significant differences were found. Urinary symptoms: acute cystitis at 3 months: 41%. At 2 years mild urinary incontinence post-Brachytherapy: 7.2%. Only 12% of patients had a worsening of urinary symptoms after treatment. Intestinal symptoms: acute proctitis at 3 months: 9%. At 2 years of follow-up toxicity was low. Only 3% of patients had increase compared to previous symptoms Sexual symptoms: Sexual function was poor at 2 years of follow-up in 16% of patients.ConclusionsBrachytherapy is an effective treatment strategy for localized prostate cancer, with excellent local control data and relatively low rate of severe adverse events. PurposeLow dose rate (LDR) Brachytherapy is used as a valid option in the treatment of localized prostate cancer. Our objective is to analyze local control and toxicity in patients treated with Brachytherapy in our center. Low dose rate (LDR) Brachytherapy is used as a valid option in the treatment of localized prostate cancer. Our objective is to analyze local control and toxicity in patients treated with Brachytherapy in our center. Material and Methods100 patients treated for prostate cancer (low and intermediate risk) with LDR brachytherapy monotherapy from 2009 to 2014. Implants permanent I-125 seeds were used. Technical data: Device First System (seed-Selectron Nucletron) with perineal guided insertion by transrectal ultrasound. Intraoperative planning technique. PSA levels and toxicity through quality test QLQ-PR25 life were monitored and validated by the EORTC (European Organization for Research and Treatment of Cancer). 100 patients treated for prostate cancer (low and intermediate risk) with LDR brachytherapy monotherapy from 2009 to 2014. Implants permanent I-125 seeds were used. Technical data: Device First System (seed-Selectron Nucletron) with perineal guided insertion by transrectal ultrasound. Intraoperative planning technique. PSA levels and toxicity through quality test QLQ-PR25 life were monitored and validated by the EORTC (European Organization for Research and Treatment of Cancer). ResultsAfter 24 months follow up, biochemical recurrence free survival was 96%. Four patients had biochemical recurrence: A patient with bone metastases confirmed by PET and two local relapses confirmed by biopsy. Regarding toxicity, when symptoms were compared pre and post implant no significant differences were found. Urinary symptoms: acute cystitis at 3 months: 41%. At 2 years mild urinary incontinence post-Brachytherapy: 7.2%. Only 12% of patients had a worsening of urinary symptoms after treatment. Intestinal symptoms: acute proctitis at 3 months: 9%. At 2 years of follow-up toxicity was low. Only 3% of patients had increase compared to previous symptoms Sexual symptoms: Sexual function was poor at 2 years of follow-up in 16% of patients. After 24 months follow up, biochemical recurrence free survival was 96%. Four patients had biochemical recurrence: A patient with bone metastases confirmed by PET and two local relapses confirmed by biopsy. Regarding toxicity, when symptoms were compared pre and post implant no significant differences were found. Urinary symptoms: acute cystitis at 3 months: 41%. At 2 years mild urinary incontinence post-Brachytherapy: 7.2%. Only 12% of patients had a worsening of urinary symptoms after treatment. Intestinal symptoms: acute proctitis at 3 months: 9%. At 2 years of follow-up toxicity was low. Only 3% of patients had increase compared to previous symptoms Sexual symptoms: Sexual function was poor at 2 years of follow-up in 16% of patients. ConclusionsBrachytherapy is an effective treatment strategy for localized prostate cancer, with excellent local control data and relatively low rate of severe adverse events. Brachytherapy is an effective treatment strategy for localized prostate cancer, with excellent local control data and relatively low rate of severe adverse events.