Proffered Presentations Archive

UK & Ireland Prostate Brachytherapy Conference 2024

Abstract number 15 

Can low dose rate brachytherapy be considered a treatment option for patients with prostate cancer with intermediate or high risk features?

Rebecca Morgan, Patrick Isola, Susannah Brock, Ben Masters
Poole General Hospital 

Purpose: Not all patients are suitable for external beam radiotherapy or surgery. This retrospective analysis aimed to see whether patients with one or more intermediate or high risk features (IHRF) could still respond well to low dose rate (LDR) brachytherapy. 

Methods: We reviewed 63 patients treated with LDR brachytherapy between 02/06/2011 and 21/12/2017, all with at least one IHRF (stage T3a prostate cancer, Gleason Score (GS) 7 (4+3) or PSA >15). 3 were excluded as they had died of unrelated conditions. The ages of patients ranged from 52-83 years. Of the 60 included patients, 7 had stage T3a and the remainder had stage T1c-T2c. 1 had GS of 6 (3+3), 9 had GS 7 (3+4), 47 had GS 7 (4+3) and 3 had GS 8. 9 patients had a PSA >15. 4 patients had 2 IHRFs and 1 had 3 IHRFs. 

Results: 83% (50/60) showed no evidence of PSA relapse at 5 years. Of the 10 patients that relapsed, 1 had 3 IHRFs, 2 had 2 IHRFs and 6 had 1 IHRF. The mean number of months to relapse was 44 (SD 34). The average PSA at the start of treatment was 12.91 in the relapse group compared to 9.19 in those who did not relapse. Of the 10 patients that relapsed, 90% had a GS 7 (4+3), whereas 78% of the total patients in this study had a GS of 7 (4+3). 

Conclusion: Our findings suggest that LDR brachytherapy can be considered a treatment option for patients with prostate cancer with certain intermediate or high-risk features. This may be particularly useful for patients unsuitable for surgery or external beam radiotherapy. However, a larger study would be needed to confirm these findings.