Poster Presentation – Abstracts Archive

UK & Ireland Prostate Brachytherapy Conference 2017

Abstract number 14

The efﬁcacy of cytoreduction as a bridge to brachytherapy in the treatment of prostate cancer – an Irish cohort

Peoples A*; O’Brien S*; Kelly P*
*Cork University Hospital/UCC

AIMS/INTRODUCTION: To determine the effectiveness of neoadjuvant cytoreductive agents as a bridge to the use of brachytherapy in the treatment of non-metastatic prostate cancer.

MATERIALS/METHODS: From January 2014 to October 2016, 23 patients underwent dual agent cytoreduction (dutasteride and bicalutamide) in Cork University Hospital. Before and after completion of 3 months of cytoreductive therapy, patients underwent transrectal ultrasound (TRUS) to assess prostate volume and the absence/presence of pubic arch interference (PAI). The variables analysed include pre- and post-treatment prostate volumes and the absence/presence of PAI.

RESULTS: The mean pre-treatment prostate gland volume in this patient group was 54.93cc (range: 39-81). The mean prostate volume following 3 months of dual agent cytoreductive therapy was 37.65cc (range: 24-48). The mean percentage change in volume was 30.58%. 21/23 patients had PAI on initial TRUS. Of those individuals with initial PAI, 9/21 had persistent PAI post treatment. 6/9 were not converted to brachytherapy. Overall, 16/23 were suitable candidates for brachytherapy following 3 months of cytoreductive therapy. Factors which precluded the remaining patients from brachytherapy included persistent PAI (6/7) and in one case an obstructive pattern on uroﬂ ow studies.

CONCLUSION: The percentage of our patients converted to suitability for brachytherapy following cytoreduction is comparable to those described previously in the literature. It is also comparable to those who report conversion to suitability using hormone therapy, albeit with an overall lower side effect proﬁ le.