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Permanent interstitial low-dose-rate brachytherapy for prostate cancer: institutional experience with implementation and predictive factors for outcome and side effects

Published online by Cambridge University Press:  22 June 2023

Felix Fels
Affiliation:
Department of Radiation Oncology, Ortenau Klinikum Offenburg-Kehl, Academic Teaching Hospital of Albert-Ludwigs University Freiburg, Offenburg, Germany
Ernest Okonkwo
Affiliation:
Department of Radiation Oncology, Ortenau Klinikum Offenburg-Kehl, Academic Teaching Hospital of Albert-Ludwigs University Freiburg, Offenburg, Germany
Jörg Günter Großmann
Affiliation:
Department of Radiation Oncology, Ortenau Klinikum Offenburg-Kehl, Academic Teaching Hospital of Albert-Ludwigs University Freiburg, Offenburg, Germany
Thomas Schadt
Affiliation:
Urological Practice Center Offenburg, Offenburg, Germany
Sebastian Laschke
Affiliation:
Practice of Urology, Lahr, Germany
György Lövey
Affiliation:
BORAD Bottrop, Radiotherapy, Bottrop, Germany
Dieter Lansing
Affiliation:
Urological Practice Center Offenburg, Offenburg, Germany BORAD Bottrop, Radiotherapy, Bottrop, Germany
Ulrich Freund
Affiliation:
Department of Radiation Oncology, Ortenau Klinikum Offenburg-Kehl, Academic Teaching Hospital of Albert-Ludwigs University Freiburg, Offenburg, Germany
Reiner Steurer
Affiliation:
Department of Radiation Oncology, Ortenau Klinikum Offenburg-Kehl, Academic Teaching Hospital of Albert-Ludwigs University Freiburg, Offenburg, Germany
Felix Momm*
Affiliation:
Department of Radiation Oncology, Ortenau Klinikum Offenburg-Kehl, Academic Teaching Hospital of Albert-Ludwigs University Freiburg, Offenburg, Germany
*
Corresponding author: Felix Momm; Email: felix.momm@ortenau-klinikum.de

Abstract

Introduction:

Low-dose-rate brachytherapy (LDR brachytherapy) with Iodine-125-seeds is an established treatment modality for low- and favourable intermediate-risk prostate cancer. Our single institution experience in this field was retrospectively studied.

Methods:

Two-hundred sixty consecutive patient records were reviewed for demographic, disease, therapy and side effect data. The patients were divided into subgroups by pre- and post-implant prostate-specific antigen (PSA) levels and by different LDR brachytherapy techniques used, that is, preoperative planning technique (PPT) versus intraoperative real-time planning (IOR). Data were analysed by Kaplan–Meier method and appropriate testing was conducted for PSA biochemical recurrence (BCR) and for toxicities.

Results:

After median follow-up of 65·0 months, 94·0% of all patients were free from BCR. This endpoint showed no significant differences by patient age, initial PSA, PSA decrease over time, Gleason score and implanted total activity. Patients with IOR were free of BCR in 98·9% (180/182) versus 76·9% (40/52) with PPT. All patients with a PSA nadir of <0·1 ng/mL were free from BCR. Six patients (2·5%) reported an incontinence grade 1. Transient nocturia/urge and dysuria appeared in 54·7% and 22·6% of patients.

Conclusions:

Consistent with literature, LDR brachytherapy for low- and intermediate-risk prostate cancer appeared highly effective for freedom from BCR with mild side effects.

Type
Original Article
Copyright
© The Author(s), 2023. Published by Cambridge University Press

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Footnotes

*

Authors contributed equally

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