Moderate dose escalation with single-fraction high-dose-rate brachytherapy boost for clinically localized intermediate- and high-risk prostate cancer: 5-year outcome of the first 100 consecutively treated patients

Péter Ágoston, Tibor Major, Georgina Fröhlich, Zoltán Szabó, József Lövey, János Fodor, Miklós Kásler, Csaba Polgár

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Purpose: To analyze the clinical outcome and toxicity data of the first 100 consecutive patients treated with a single-fraction high-dose-rate brachytherapy (HDR-BT) and external beam radiotherapy (EBRT). Methods and Materials: Two-hundred eighty patients have been treated with HDR-BT boost for localized intermediate- to high-risk prostate cancer. Among these, the outcome and toxicity of the first 100 patients treated with a single HDR-BT fraction were assessed. A median dose of 60. Gy EBRT was given to the prostate and vesicles. Interstitial HDR-BT of 10. Gy was performed during the course of EBRT. Results: Median followup time was 61.5 months. The 5-year actuarial rates of overall survival, cause-specific survival, disease-free survival, and biochemical no evidence of disease (bNED) for the entire cohort were 93.3%, 99.0%, 89.3%, and 85.5%, respectively. The 7-year actuarial rate of bNED was 84.2% for the intermediate-risk group and 81.6% for the high-risk group (p=0.8464). The 7-year actuarial rates of bNED for Grade 1, 2, and 3 tumors were 97.5%, 80.0%, and 67.1%, respectively. The 5-year probability for developing late Grade 3 gastrointestinal and genitourinary (GU) toxicity was 2.1% and 14.4%, respectively. Grade 3 GU complications occurred significantly more frequently in patients with a history of preirradiation transurethral resection (29.1% vs. 8.8%; p=0.0047). Conclusions: Five-year outcome after 60. Gy EBRT plus a single fraction of 10. Gy HDR-BT boost is encouraging. Preradiation transurethral resection significantly increases the risk of late severe GU complications.

Original languageEnglish
Pages (from-to)376-384
Number of pages9
JournalBrachytherapy
Volume10
Issue number5
DOIs
Publication statusPublished - Sep 1 2011

Keywords

  • Boost
  • External beam radiotherapy
  • High-dose-rate brachytherapy
  • Prostate cancer

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

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