OC-0271: the Clinical Outcome after High Dose Rate Brachytherapy As Monotherapy in Localized Prostate Cancer

ESTRO 36 _______________________________________________________________________________________________≤60cc; no use of androgen deprivation and no previous prostate surgery.The patients were monitored prospectively for toxicity (CTCAE v. 3.0) and health-related quality of life (Expanded Prostate Cancer Index Composite [EPIC]).A clinically significant decrement was considered an EPIC score decrease greater than one-half of the SD of the baseline value for each domain.Patient satisfaction was evaluated using a five-category predetermined Likert scale question. ResultsThe median age was 71 years (range 55-78), median initial PSA 7.05 ng/ml (4.2-17.8)and median baseline IPSS was 5 (0-14).Forty-four percent of the patients were low-risk and 56% intermediate-risk.The median prostate volume was 34cc (17-60).Median CTV and OAR doses were: V100: 96.5% (95-99.4),V150 20.5% (13.7-35.1),V200 5.3% (3.1-10.1),Urethral Dmax 106% (103-111) and rectum 2cc 53 % (45-48) After a median follow-up is 16 months (3-31), acute grade-2 genitourinary and gastrointestinal toxicity occurred in 4 patients (9%) and 2 patients (2.3%), respectively.Two patients presented late GU grade-2 toxicity (4.6%).No grade-3 toxicity occurred.In terms of QoL, there was a statistically significant decline in EPIC urinary urgency domain between month 1 and month 6 (p=0.006), and returned to baseline by month 12. Mean EPIC urinary irritative-obstructive, bowel, sexual and hormonal domains did not present significant changes.Of patients potent at baseline evaluation, 60% remained potent at last follow-up.Patients rated their satisfaction at 6 months as "verysatisfied" (23%) or "extremely-satisfied" (77%). ConclusionHDR brachytherapy monotherapy administered in a single fraction of 19Gy, demonstrate excellent results in terms of toxicity, tolerance, safety, patient satisfaction and QoL.Longer follow-up is needed to confirm the efficacy of this strategy.