High-dose-rate brachytherapy combined with hypofractionated external beam radiotherapy for men with intermediate or high risk prostate cancer: analysis of short- and medium-term urinary toxicity and biochemical control.

摘要: The best management of localized and locally advanced prostate cancer remains controversial, but there are clinical evidences that for patients considered unfavorable outcome dose escalation radiotherapy has a significantly better outcome. Methods: Between 2005-2009 total 39 were treated in phase I-II trial with high-dose rate (HDR)- 30 Gy given by 4 fractions BID, two separated implants hypofractionated conformal/tri-dimensional (hEBRT) - 45 (3 per fraction 3 weeks), at Hospital AC Camargo, Sao Paulo, Brazil. Results: Median age was 69 (range, 58-80) years old. With median follow up 42.5 months the highest RTOG acute severe genitourinary toxicity (GU-TX) grade (5.1%) patients. Late GU-TX observed one (2.6%) patient. On univariate analysis volume > 45cc (p=0.024), 130% prescribed (p as only predictive factor late GU-TX, p=0.017 (95%CI-1.39-29.49), HR-6.4. actuarial overall survival, biochemical control disease specific survival rates entire group 3.5-years 92.0%, 87.6% 96.9%, respectively. Conclusion: HDR combined to hEBRT is well tolerated short medium term. Acute minimal improved outcomes terms reduced can be achieved using least 11 needles no more than implanted. maximum urethral should kept bellow dose.