ONCOmmunity

LDR brachytherapy offers superior tumor control to single-fraction HDR prostate brachytherapy: A prospective study.

By: Isabel E Jimenez-Garcia, Sebastia Sabater, Rocio Martinez-Gutierrez, Pedro Sanchez-Galiano, Roberto Berenguer-Serrano, Susana Castro-Larefors, Irene Rey-Lopez, Beatriz Ruiz-Herrero, Ricardo Sánchez-Prieto, Angeles Rovirosa, Meritxell Arenas, Herminio A Gonzalez-Suarez

Department of Radiation Oncology, Complejo Hospitalario Universitario de Albacete (CHUA), Albacete, Spain.
2023-3-30; doi: 10.1002/pros.24548

Abstract

Purpose

To compare the clinical outcomes of single-fraction high-dose-rate (HDR) brachytherapy and single-fraction low-dose-rate (LDR) brachytherapy as the sole treatment for primary prostate cancer.

Material

A quasi-randomized study that allocated, from March 2008 to February 2012, 129 low and intermediate risk prostate cancer patients to one single-fraction HDR of 19 Gy (61 patients) or to a 145 Gy ¹²⁵ I LDR permanent implant (68 patients. Biochemical relapse-free survival (bRFS) and overall survival (OS) were compared using the Kaplan-Meier method and Cox regression analysis.

Results

After a median follow-up of 72 months in the HDR group, 26 patients relapsed, and after a median follow-up of 84 months in the LDR group, 7 patients relapsed (p < 0.0001). The 5-year bRFS was significantly better for the LDR group than for the HDR group (93.7% and 61.1%, respectively) (p < 0.0001). The 5-year OS also was significantly better in the LDR group (95.5% vs. 89.9%) (p = 0.0436).

Conclusions

Permanent LDR prostate implant brachytherapy offers better clinical outcomes than single-fraction HDR for prostate cancer.