External beam radiotherapy plus high-dose-rate brachytherapy for treatment of locally advanced prostate cancer: The initial experience of the Catalan Institute of Oncology
Received 17 September 2008; received in revised form 8 January 2009; accepted 7 May 2009. published online 07 September 2009.
Abstract
Purpose
The objective of this study was to report initial outcomes in patients with locally advanced prostate cancer (CaP) who underwent external beam radiation therapy (EBRT) treatment combined with high-dose-rate brachytherapy (HDR-BT) as a boost.
Methods and Materials
From 2002 to 2007, 114 CaP patients underwent EBRT followed by 192I HDR-BT. The patients were classified into intermediate- (Group 1) or high- (Group 2) risk groups. The mean total EBRT dose was 60.0Gy (95% confidence interval [CI]: 59.9–60.1) at 2Gy per fraction. After a mean of 20.6 days (95% CI: 18.4–22.8), all the patients received a single-fraction 9-Gy dose of HDR-BT boost. Of the 114 patients in the study, 103 (90.4%) underwent up to 3 years of complete androgen deprivation therapy after diagnosis.
Results
The mean followup for the entire group was 32.1 months (95% CI: 29.9–34.4). The 4-year biochemical failure-free survival rate was 97.4% and treatment was well-tolerated.
Conclusions
Preliminary biochemical control rates after EBRT plus one fraction of 9-Gy HDR-BT are encouraging. This atypical fractionation schedule is cost-effective and reduces patient discomfort and treatment-related risks. More followup is required to confirm these findings.
Corresponding author. Department of Radiation Oncology, Catalan Institute of Oncology (ICO), University of Barcelona (UB), Gran vía s/n, Km 2, 7, 08907 L'Hospitalet de Llobregat, Barcelona, Spain. Tel.: +34-93-2607722; fax: +34-93-2607725.
ABSTRACT