Prostate Brachytherapy UK & Ireland 11-12 June 2026

Abstracts Archive

UK & Ireland Prostate Brachytherapy Conference 2011

Abstract number 2

Single fraction HDR boost.  Report of toxicity from a single centre experience

JP Wylie, Christie Hospital, Manchester
P Mandall, Christie Hospital, Manchester
JP Logue, Christie Hospital, Manchester

Introduction: High dose rate (HDR) brachytherapy provides a convenient way of delivering high dose fractions of radiotherapy.  This is typically delivered as a boost in conjunction with a course of external beam radiotherapy and given in 2-3 fractions.  Multiple fractions erode the convenience of this modality to both the patient and treating team and may fail to fully exploit the low alpha beta ratio reported for prostate cancer.  We report our experience of delivering HDR brachytherapy as a single fraction of 12.5 -15 Gy prior to 37.5 Gy given via conventional conformal radiotherapy. 

Methods: Patient data was extracted from a prospective database sponsored by Nucletron.  Patient demographics are entered at the time of treatment and postal questionnaires detailing LENT SOMA, IPSS, EPIC QoL, catheter and alpha blocker usage were sent to the patient pre-treatment, 6 weeks after, then 6,12,18,24,36 and 48 months post treatment.  All patients received 3 months neo-adjuvant hormones followed by adjuvant hormones for 6-24 months dependant on perceived risk.

Results: Between July 2008 and February 2011 177 patients were treated.  Median age was 67 years (range 51-78), median Gleason score was 7 (range 6-10) and median initial PSA 16 (range 0.29-102).  Overall toxicity was modest.  IPSS peaked at 6 weeks and approached baseline at 6 months.  LENT SOMA bowel symptoms peaked at 6 months and approached baseline at 12 months.  There was no appreciable difference in reported toxicity between the initial cohort treated with 12.5 Gy and those receiving 15 Gy. 

Conclusions: Single fraction HDR boost appears a safe and convenient means of dose escalating.  A single fraction of 15 Gy is now our standard and has been adopted by several other U.K. brachytherapy centres.