High-Dose-Rate Brachytherapy as Monotherapy Delivered in Two Fractions Within One Day for Favorable/Intermediate-Risk Prostate Cancer: Preliminary Toxicity Data

Feasibility and early outcome of high-dose-rate Ir-192 brachytherapy as monotherapy in two fractions within 1 day for high-/very high-risk prostate cancer

“…The AE data presented are similar to the data from a previously published HDR monotherapy series (11), which favorably compared with those from an LDR-BT series (12)(13)(14)(15). Zelefsky et al (16) reported that the 5 year likelihood of urethral stricture development was 10%, and the median duration until stricture development was 18 months.…”

“…Notably, when applying the standard linear quadratic model [BED = number of fractions x dose per fraction (1+d/α/β)], with an α/β ratio of 1.5, the BED of the 13.5 Gy (x2) schedule was 261 Gy, which is markedly higher compared with the BED of the EBRT schedule of 1.8 Gy (x45; BED = 178 Gy) (11).…”

Quality of life after high-dose rate brachytherapy monotherapy for prostate cancer.

“…Management options for patients with low or intermediate risk prostate cancer and a life expectancy of less than 10 years include active surveillance (1), radical prostatectomy (2), external beam radiation therapy (EBRT), low-dose rate (LDR) brachytherapy monotherapy (3,4), or high-dose--rate (HDR) brachytherapy (5,6). Since cure rates are similar among these treatment options (7), health-related quality of life (HRQOL) is an important factor in a patient's decision-making process (8).…”

Radiation Therapy for Prostate Cancer

“…Urinary retention occurs in less than 5% of patients treated with combination of HDR brachytherapy and EBRT [89,94,104,105]. Urinary strictures are reported in up to 15% of patients, and most commonly seen in the bulbomembranous urethra [106,107].…”

“…Single higher dose fraction also becomes used for dealing with the issue of needle displacement between each fraction [92]. More recently, several institutes have used HDR brachytherapy as monotherapy without the addition of EBRT, largely for low-risk, but also for intermediate-and highrisk patients [93][94][95][96][97][98][99].…”