Feasibility and toxicity of a single fraction high-dose-rate brachytherapy followed by a course of EBRT for localized prostate cancer, a retrospective study: The Polyclinique Courlancy experience

Purpose. - Evaluate the feasibility and toxicity of radiation dose escalation delivered with a single fraction high-close-rate (HDR) brachytherapy boost followed by external beam radiotherapy for intermediate and high risk localized prostate cancer - a retrospective study. Patients and methods. - Between December 2004 and December 2008, 61 patients with intermediate risk or high-risk localized prostate cancer received a single 10 Gy fraction of interstitial HDR brachytherapy followed by a 64 Gy course of external beam radiation therapy. Dose Volume histograms. conformity index and side effects were systematically analyzed. Results. - HDR brachytherapy dosimetric criteria were respected. Early side effects (<= 3 months after full treatment): 30% reported grade 2 or grade 3 urinary toxicity and 26% reported grade 2 or grade 3 bowel toxicity were reported. Late side effects (>3 months): 12% reported grade 2 or grade 3 urinary toxicity and 5% reported grade 2 or grade 3 bowel toxicity were reported. No patients reported any grade 4 late toxicity events. Three months after treatment, 7% grade 1,25% grade 2 and 39% grade 3 erectile dysfunction were reported. Conclusion. - Our monofractionation protocol is an easy technique to implement logistically. Acute and late toxicities are acceptable and comparable to those published by Various teams Mostly using multifractionation protocols. A longer follow-up is required to assess the effect of this dose escalation protocol on long-term biological control. (C) 2009 Societe francaise de radiotherapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.