Abstracts Archive

UK & Ireland Prostate Brachytherapy Conference 2011

Abstract number 1

LDR Brachytherapy should be considered in Young Men with Prostate Cancer

Eliot Chadwick, Royal Surrey County Hospital
Stephen EM Langley, Royal Surrey County Hospital
Robert W Laing, Royal Surrey County Hospital

Introduction
Brachytherapy achieves similar rates of biochemical control to radical prostatectomy in young men with prostate cancer. However, radical prostatectomy continues to be favoured in spite of known toxicity. The outcomes and toxicity for the only prospective UK series of young men treated by brachytherapy are presented.

Methods
Between 1999 and 2010, 118 out of 1700 patients treated by brachytherapy were <55 years old, Depending on MSKCC risk classification patients were treated with monotherapy (88), or with hormones (25) and/or EBRT (18). The implant technique has evolved with time from a 2-stage Seattle approach to a one-stage, real-time procedure. A bespoke, prospective database was used to collect clinical data.

Results
Overall survival was 100%. 76 patients had >3 years follow up, mean 76m. Of these 4 showed biochemical failure: 2 in low and 2 in high risk groups. Actuarial 8 year PSA free survival for the whole <55yrs group was 94% (cf. 84% for all ages). For the entire cohort, the median 5 year IPSS and QoL were 4 and 1.5 respectively.  Of the 75% patients potent pre-op, 81% retained potency (IIEF>11).  No secondary malignancies have been reported.

Conclusions
This is the first reported UK series of young men treated with LDR brachytherapy. The mature data demonstrates very effective tumour control and it is well tolerated.  When treatment is discussed with this patient group, LDR brachytherapy should be considered where appropriate.