One Minute Poster Pitches Archive

UK & Ireland Prostate Brachytherapy Conference 2024

Abstract number 14 

An analysis of LDR prostate brachytherapy outcomes in a single centre over 18 years 

Bowen J, Mirza S, Al-Eryani K, Berman B, O’Hea I, Hodgson D
Portsmouth Hospitals University NHS trust 

Purpose: Low dose rate (LDR) brachytherapy is a well-established treatment option for prostate cancer in appropriate patients. Our local service started in 2005. We present a review of our outcomes since. 

Methods: We performed a single-centre retrospective analysis of all 310 patients who underwent prostate brachytherapy between 2005 and 2023. Total population analysis assessed trends in patient demographics, Gleason grade at diagnosis and D90 dosimetry calculated on a CT scan approximately a month after implant. 

Subset analysis was performed on 125 patients who underwent brachytherapy between 2005 and 2013 (before our target D90 dose increased from >135Gy to >140Gy), to assess the correlation between dosimetry and oncological outcomes. 

Results: Analysis demonstrated a higher proportion of ISUP (International Society of Urological Pathology) group 2 and 3 disease, rather than group 1, in recent years. D90 dosimetry has also increased over the course of our service. 

Post implant dosimetry ranged from 56.88 to 214 with a median dose of 149.9. Follow-up duration ranged from 1 to 19 years. 

In our subset analysis, we know that at least 22 of 125 patients (16.8%) required further prostate cancer treatment. Hormone therapy was given to 16 patients (13%) and chemotherapy to 5 (4%). Overall mortality rate was 23%, with 6% related to prostate cancer. 

Conclusion: The increased Gleason grade of our population is an interesting finding and may represent a conscious shift away from over-treatment of men with low-risk prostate cancer. Our subset analysis has indicated a significant proportion of patients going on to require further treatment and our next step will be to extend our review to assess whether this holds true for those patients treated since 2013.