PMID- 25018002 OWN - NLM STAT- MEDLINE DCOM- 20150528 LR - 20220410 IS - 1879-0887 (Electronic) IS - 0167-8140 (Linking) VI - 112 IP - 1 DP - 2014 Jul TI - High-dose-rate brachytherapy with two or three fractions as monotherapy in the treatment of locally advanced prostate cancer. PG - 63-7 LID - S0167-8140(14)00255-2 [pii] LID - 10.1016/j.radonc.2014.06.007 [doi] AB - BACKGROUND: To evaluate late urinary (GU) and gastrointestinal (GI) adverse events (AEs) and biochemical control of disease after high-dose rate brachytherapy (HDR-BT) in locally advanced prostate cancer. PATIENTS AND METHODS: 227 consecutive patients were treated with 3 x 10.5 Gy (n = 109) or 2 x 13 Gy (n = 118) HDR-BT alone. Biochemical failure was assessed using the Phoenix definition of PSA nadir + 2 mug/l and late AEs using the RTOG scoring system and the International Prostate Symptom Score (IPSS). RESULTS: Kaplan-Meier estimates and prevalence of late events indicate that urinary, bowel and IPSS symptoms are higher after 31.5 Gy than after 26 Gy, however differences are significant only for Grade 1 and 2 urinary toxicity. Kaplan-Meier estimates of morbidity are consistently and considerably higher than time-point estimates of prevalence; which reflects the transient nature of most symptoms. At 3 years 93% and 97% of patients treated with 26 and 31.5 Gy, respectively, were free from biochemical relapse (p = 0.5) and 91% for the latter regimen at 5 years. In univariate and multivariate analysis risk-category was the only significant predictor of relapse (p < 0.03). CONCLUSION: These HDR-BT schedules achieved high levels of biochemical control of disease in patients with advanced prostate cancer with few severe complications seen throughout the first 3 years. CI - Copyright (c) 2014 Elsevier Ireland Ltd. All rights reserved. FAU - Hoskin, Peter AU - Hoskin P AD - Cancer Centre, Mount Vernon Hospital, Northwood, UK. FAU - Rojas, Ana AU - Rojas A AD - Cancer Centre, Mount Vernon Hospital, Northwood, UK. Electronic address: arc03@btconnect.com. FAU - Ostler, Peter AU - Ostler P AD - Cancer Centre, Mount Vernon Hospital, Northwood, UK. FAU - Hughes, Robert AU - Hughes R AD - Cancer Centre, Mount Vernon Hospital, Northwood, UK. FAU - Alonzi, Roberto AU - Alonzi R AD - Cancer Centre, Mount Vernon Hospital, Northwood, UK. FAU - Lowe, Gerry AU - Lowe G AD - Cancer Centre, Mount Vernon Hospital, Northwood, UK. FAU - Bryant, Linda AU - Bryant L AD - Cancer Centre, Mount Vernon Hospital, Northwood, UK. LA - eng GR - G0701945/MRC_/Medical Research Council/United Kingdom PT - Clinical Trial PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20140710 PL - Ireland TA - Radiother Oncol JT - Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology JID - 8407192 RN - EC 3.4.21.- (KLK3 protein, human) RN - EC 3.4.21.- (Kallikreins) RN - EC 3.4.21.77 (Prostate-Specific Antigen) SB - IM MH - Adenocarcinoma/blood/pathology/*radiotherapy MH - Aged MH - Aged, 80 and over MH - Brachytherapy/adverse effects/*methods MH - Dose Fractionation, Radiation MH - Gastrointestinal Diseases/etiology MH - Humans MH - Kallikreins/blood MH - Male MH - Male Urogenital Diseases/etiology MH - Middle Aged MH - Neoplasm Recurrence, Local/blood/*pathology MH - Prostate-Specific Antigen/blood MH - Prostatic Neoplasms/blood/pathology/*radiotherapy MH - Radiation Injuries/etiology MH - Radiotherapy Dosage MH - Treatment Outcome OTO - NOTNLM OT - Biochemical relapse OT - High-dose-rate brachytherapy OT - Late adverse events OT - Monotherapy OT - Prostate cancer EDAT- 2014/07/16 06:00 MHDA- 2015/05/29 06:00 CRDT- 2014/07/15 06:00 PHST- 2013/06/22 00:00 [received] PHST- 2014/05/02 00:00 [revised] PHST- 2014/06/14 00:00 [accepted] PHST- 2014/07/15 06:00 [entrez] PHST- 2014/07/16 06:00 [pubmed] PHST- 2015/05/29 06:00 [medline] AID - S0167-8140(14)00255-2 [pii] AID - 10.1016/j.radonc.2014.06.007 [doi] PST - ppublish SO - Radiother Oncol. 2014 Jul;112(1):63-7. doi: 10.1016/j.radonc.2014.06.007. Epub 2014 Jul 10.