Oral & Poster Presentation – Clinical Abstracts Archive
UK & Ireland Prostate Brachytherapy Conference 2016
Abstract number 9
Long-term biochemical control and morbidity outcomes with HDR prostate brachytherapy boost in combination with external beam radiotherapy
Teo M*; Sun F*; Bownes P*; Henry A*; Bottomley D*; Rodda S*
*St James Institute of Oncology, Leeds
AIMS/INTRODUCTION: HDR brachytherapy boost in combination with external beam radiotherapy (EBRT) and short term androgen deprivation therapy (ADT) is an effective treatment in locally advanced intermediate- and high-risk prostate cancer. This study reports the long-term biochemical control and morbidity outcomes from our institution.
MATERIALS/METHODS: Data from patients treated with HDR brachytherapy boost in combination with EBRT was extracted from electronic clinical notes. Patients who were on androgen deprivation therapy for over 12 months were excluded from the analysis, leaving 95 evaluable patients. All patients received either 17Gy in two fractions or 15 Gy in a single fraction of HDR brachytherapy boost followed by external beam radiotherapy 37.5Gy in 15 fractions. Seventy percent of patients received androgen deprivation therapy (ADT) for less than or equal to 6 months, 15% received 6-12 months ADT treatment, and 15% received no hormones. Biochemical relapse was defined using the Phoenix definition.
RESULTS: Median follow-up was 52 months. Median PSA at last follow-up was 0.19. There were 13 relapses – 3 biopsy-proven local relapses, 4 radiological distant relapses and 6 biochemical relapse only. 4-year biochemical relapse-free survival was 91.2%. There were late RTOG grade 3+ urinary toxicity in 6(6.3%) patients – 5 irritable urinary symptoms and 1 urethral stricture requiring dilatation. There were late RTOG grade 3+ bowel toxicity in 3 (3.2%) patients – 2 per rectal bleeding and 1 proctitis requiring steroid enemas.
CONCLUSIONS: HDR brachytherapy boost with EBRT provides good biochemical control with acceptable urinary and bowel late toxicity.