Feasibility study combining low dose rate 192Ir brachytherapy and external beam radiotherapy aiming at delivering 80–85 Gy to prostatic adenocarcinoma

摘要: Abstract Background : Increasing the radiation dose to prostatic adenocarcinoma has provided higher local control rates. A total of 80 Gy seem necessary achieve this goal but patient set-up and prostate motion remain difficult problems solve in conformal radiotherapy. Brachytherapy which overcomes these points could be an alternative way external beam boost fields. We wanted transpose irradiation models largely used cervix cancer treatment combining radiotherapy low rate brachytherapy. Materials methods In 71 patients with 19.5 13 ng/ml mean median PSA levels, respectively, a escalation from 74 85 was performed four groups. Results Shifting intraoperative placement sources vectors (Group I) positioning under ultrasound controls (groups II–IV), improving implantation shape optimizing delivery urethral bed have reduced rectal wall 65 urethra 100 Gy. Rectal/prostate ratio lowered 0.7 (Groups I–II) 0.58 III–IV) while avoiding resulting pelvic bone arch interference, volume or seminal vesicles location. The follow-up periods are 28 18 months. Groups III IV 85% without hormonotherapy treated 80–85 normalized 1 within 6 No severe late effect been noted for implanted echographic control. Conclusions method described allows deliver Longer is however needed levels delivered not expected induce prohibitive side effects.