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High Dose Rate and External Beam Radiotherapy in Locally Advanced Prostate Cancer

Viani, Gustavo Arruda MD; Pellizzon, Antonio Cássio MD, PhD; Guimarães, Flavio Silva MD; Jacinto, Alexandre Arthur MD; dos Santos Novaes, Paulo Eduardo Ribeiro MD, PhD; Salvajoli, João Vitor MD, PhD

American Journal of Clinical Oncology: April 2009 - Volume 32 - Issue 2 - p 187-190
doi: 10.1097/COC.0b013e3181841f78
Original Article: Genitourinary

Purpose: To report the outcomes and toxicity of high dose rate brachytherapy as a boost for localized prostate cancer.

Materials and Methods: Between 1997 and 2000, the medical records of 131 patients with prostate adenocarcinoma who were treated with external beam radiation therapy and high dose rate brachytherapy, were retrospectively analyzed. Furthermore, 55% of the patients received neoadjuvant/concurrent or adjuvant androgen deprivation therapy. Patients were stratified into 2 groups. Group 1 included 65 patients with Gleason score 7, pretreatment prostate specific antigen (PSA) between 10 and 20 ng/mL, and clinical stage T2b. Group 2 included 66 patients with Gleason score between 8 and 10, PSA greater than 20 ng/mL, and clinical stage greater than T2b.

Results: At a median follow-up of 62.8 months, the 5-year biochemical control (BC) rate, as defined by the American Society for Therapeutic Radiology and Oncology Phoenix Consensus panel statement, was 81% and overall survival was 91%. BC in Groups 1 and 2 were 87% and 71%, respectively. On univariate analysis risk group, pretreatment PSA and age were significant predictors of BC. However, on multivariate analysis only pretreatment PSA was significant. Using the Radiation therapist oncology group criteria, there were 2 (1.5%) cases of grade 3 acute urinary toxicity. Regarding late side effects (n = 5), 4% of patients had grade 3 genitourinary toxicity and no grade 4 complication was observed.

Conclusions: External beam radiation therapy and high dose rate brachytherapy for prostate cancer resulted in excellent BC, and overall survival with minimal severe, acute, or late complications.

From the Radiation Oncology Department, Hospital do Cancer, São Paulo, Brazil.

Reprints: Gustavo Arruda Viani, MD, Street Tamandare, number 1029, apartment 32, São Paulo, Brazil. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.