Permanent prostate brachytherapy in prostate glands <20 cm(3)

Area of Science:

• Urology
• Radiation Oncology
• Oncology

Background:

• Prostate brachytherapy is a treatment option for localized prostate cancer.
• Optimizing dosimetry and assessing outcomes are crucial for treatment success.
• Small prostate gland volumes (<20 cm(3)) present unique considerations for brachytherapy.

Purpose of the Study:

• To evaluate dosimetry, treatment-related morbidity, and biochemical outcomes of brachytherapy in patients with small prostate glands (<20 cm(3)).

Main Methods:

• A cohort of 104 patients with prostate glands <20 cm(3) underwent brachytherapy between 1996 and 2006.
• Prostate, urethral, and rectal dosimetry were assessed.
• Urinary and rectal morbidity were evaluated using patient questionnaires.
• Cause-specific survival, biochemical progression-free survival, and overall survival were recorded.

Main Results:

• Median follow-up was 5.0 years with a median pre-treatment volume of 17.6 cm(3).
• Excellent day 0 dosimetry was achieved (V100 98.5%, D90 126.1%).
• No RTOG grade III or IV rectal complications occurred; International Prostate Symptom Score resolved in a median of 4 months.
• At 9 years, cause-specific survival was 100%, biochemical progression-free survival was 92.5%, and overall survival was 77.8%.

Conclusions:

• Brachytherapy is highly effective for small prostate glands, demonstrating excellent postimplant dosimetry.
• The treatment offers an acceptable morbidity profile and favorable biochemical outcomes.
• These findings support brachytherapy as a viable option for patients with small prostate glands.