HDR brachytherapy combined with external beam radiation for localised prostate cancer: Early experience from the Sydney Cancer Centre

Deborah Whalley, Nitya Patanjali, Michael Jackson, Aimee Lovett, Mark Chatfield, George Hruby

Research output: Contribution to journalArticle


Introduction: To report the toxicity and early efficacy of high-dose rate brachytherapy (HDR) as a boost to external beam radiation (EBRT) in the treatment of localised prostate cancer.

Methods: Between December 2002 and November 2007, 101 consecutive patients with intermediate or high risk prostate cancer were treated with EBRT plus an HDR boost. The HDR boost was initially delivered in three fractions of 6.5 Gy each via one implant; this was subsequently modified to a two-fraction technique with separate implants 2 weeks apart (8.5 Gy each). Most patients also received at least 3 months of androgen ablation.

Results: Our cohort included 65 intermediate risk and 36 high-risk patients. Sixty-seven patients received the three-fraction regime; 34 the two-fraction schedule. Median follow-up was 56 months, at which time 82% of patients were free from failure. The 4-year disease-free survival for intermediate and high-risk groups was 95% and 66%, respectively (overall 85%). Significant acute toxicities included clot retention (eight patients), one traumatic urethral injury, one case of retention requiring suprapubic catheter placement, one case of new onset atrial fibrillation and three cases of pulmonary emboli. At 4 years, the rate of late grade 2 genitourinary toxicity was 8%; two patients experienced grade 3 toxicity. No late grade 3 gastrointestinal toxicity was observed. Potency was preserved in 72% of those patients reporting normal pre-treatment sexual function.

Conclusions: Our cohort experienced toxicity similar to previously published HDR boost series with very promising early efficacy results.
Original languageEnglish
Pages (from-to)220-226
Number of pages7
JournalJournal of Medical Imaging and Radiation Oncology
Issue number2
Publication statusPublished - Apr 2012


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