Permanent prostate brachytherapy and short-term androgen deprivation for favorable and unfavorable intermediate risk: Clinical results for median 5 year follow-up.

Abstract

e554 Background: The option of prostate brachytherapy for intermediate risk is discuss. We present mature results of permanent prostate brachytherapy and short-term androgen deprivation for favourable and unfavourable intermediate risk. Methods: From 01/2006 through 12/2012, 707 patient were treated by real time iodine brachytherapy. 135 intermediate risk, 72% favourable and 28% unfavourable were include. Unfavourable was define as a gleason 7 (4+3) or > 50 % positive biopsy or 2 intermediate factors. Neoadjuvant with or without adjuvant androgen deprivation therapy was administered to 94% patients. 91 % of patients have a duration of hormone ≤ 6 mouths. 40% had vesicle seminal biopsy. 62 % had a lymph node dissection. 75 % had a bone scan. 95% had a MpMRI with tumour index in 72 %. All patients with DIL on MpMRI had a focused real time image guided brachytherapy. Tumour control was measure with phoenix definition and death with Kaplan-Meier method. The GU and GI toxicity were measure with IPSS and CTCAE V 3, IIEF-5. Results: The mean Number of seeds used was 63 ( SD, 13). Mean prostate volume was 27 cm3 (SD, 11) and 70cc maximum. Mean dose to 90% of the prostate was 188 Gy (SD, 9). Ud30 (mean, 189 Gy; SD, 10). RD2cc (mean, 105Gy; SD, 22). Mean duration of hormone was 5,6 mouths (SD,1,6). The biologic disease free survival at 5 and 8 years were 97,1 % and 94%. The global survival at 5 and 8 years were 98%. The urinary symptoms return to the baseline at 2 years with maximum toxicity at 1 month. 2 GU grade 3. GI grade 1 2 and 3 were 34%, 15% and 0%. 20% of patients with IIEF > 16 at baseline had sexual intercourse at Two years. Conclusions: Our single-institution study with a median 5-year follow-up showed that permanent prostate brachytherapy and short-term androgen deprivation risk was safe and effective for patients with favourable and unfavourable intermediate risk prostate cancer. However the association of hormone decrease the sexual function. The place of the hormone must be explore in selected intermediate risk treated by brachytherapy.