[Interstitial high dosage irradiation of prostate carcinoma]

Between 1986 and 1995 a hundred and seventy-four patients with prostate cancer staged for T1b-T3c N0 M0 were treated with a combined tele- and HDR brachytherapy regimen. The distribution of stage and grading was as follows: T1b two patients, T2a-2c 113 patients T3a-3c 59 patients, and G1 27 patients, G2 87 patients, G3 60 patients respectively. The total dose administered for the subclinical disease (small pervis) was 50 Gy by teletherapy and 30 Gy via two fractions of 15 Gy HDR brachytherapy integrated in the percutaneous regime. Total treatment time 6 weeks. After a median follow-up of 50 months (8-103) the stage related systemic and local progression amounts for stage T3 15.25% and for stage T1-2 20.43%, respectively. The distribution of systemic and local progression related to histological grading is: for Grade G3 23.3% and for Grade G1-2 6.14%. Ten patients died tumor related and 18 others of intercurrent diseases. The overall survival amounts 84%, the cancer specific survival 94% and the disease free survival 88% respectively. The late radiation morbidity scored by the RTOG/EORTC score in relation to proctitis was: 12 Patients Grade I, 10 patients Grade II, and 5 cases (one of five with abdominal anus) Grade III, respectively. In terms of radiogenic cystitis 13 patients developed Grade I side effects, 5 Grade II, and 3 Grade III, respectively. One osteoporotic patient developed a radionecrosis of both bones.