Low-dose-rate brachytherapy as a minimally invasive curative treatment for localised prostate cancer has excellent oncological and functional outcomes: a retrospective analysis from a single centre.

Abstract

IntroductionLow-dose-rate (LDR) brachytherapy is a widely used therapeutic option for localised prostate cancer. The aim of this study was to analyse the oncological and functional outcomes after 10 years of experience with brachytherapy for localised prostate cancer.Material and methodsAll patients who underwent brachytherapy between April 2006 and September 2017 were included for analysis. Initial prostate-specific antigen (PSA) levels, tumour stages, Gleason scores, positive biopsies, prostate volumes, dosimetric parameters, and urinary symptoms were noted.ResultsA total of 201 patients underwent brachytherapy between April 2006 and September 2017. Of these patients, 159 had >3 years of oncological and functional follow-up. Only these relevant patients were included in the statistical analysis. This showed a significant, persistent decline in PSA levels (p <0.0001): the mean PSA was 1.2 ng/ml after 6 months, 1.1 ng/ml after 1 year, and 0.49 ng/ml after 3 years. Only 9 patients had tumour recurrence (3 patients with Gleason score 6 and 6 patients with Gleason score 7). After receiving adequate treatment, the patients underwent oncological follow-up.Important obstructive and irritative complaints were most pronounced during the first 9 months and decreased strongly after 18 months of follow-up.ConclusionsLDR brachytherapy has excellent oncological outcomes with limited functional inconveniences that are adequately treatable. Our 10 years' experience shows that brachytherapy is a safe and effective method for the treatment of low-risk localised prostate cancer.