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. 2023 Aug;83(11):1068-1075.
doi: 10.1002/pros.24548. Epub 2023 May 7.

LDR brachytherapy offers superior tumor control to single-fraction HDR prostate brachytherapy: A prospective study

Isabel E Jimenez-Garcia  1 , Sebastia Sabater  1 , Rocio Martinez-Gutierrez  2 , Pedro Sanchez-Galiano  3 , Roberto Berenguer-Serrano  4 , Susana Castro-Larefors  1 , Irene Rey-Lopez  1 , Beatriz Ruiz-Herrero  1 , Ricardo Sánchez-Prieto  5   6 , Angeles Rovirosa  7 , Meritxell Arenas  8 , Herminio A Gonzalez-Suarez  2
Affiliations

LDR brachytherapy offers superior tumor control to single-fraction HDR prostate brachytherapy: A prospective study

Isabel E Jimenez-Garcia et al. Prostate. 2023 Aug.

Abstract

Purpose: To compare the clinical outcomes of single-fraction high-dose-rate (HDR) brachytherapy and single-fraction low-dose-rate (LDR) brachytherapy as the sole treatment for primary prostate cancer.

Material and methods: A quasi-randomized study that allocated, from March 2008 to February 2012, 129 low and intermediate risk prostate cancer patients to one single-fraction HDR of 19 Gy (61 patients) or to a 145 Gy 125 I LDR permanent implant (68 patients. Biochemical relapse-free survival (bRFS) and overall survival (OS) were compared using the Kaplan-Meier method and Cox regression analysis.

Results: After a median follow-up of 72 months in the HDR group, 26 patients relapsed, and after a median follow-up of 84 months in the LDR group, 7 patients relapsed (p < 0.0001). The 5-year bRFS was significantly better for the LDR group than for the HDR group (93.7% and 61.1%, respectively) (p < 0.0001). The 5-year OS also was significantly better in the LDR group (95.5% vs. 89.9%) (p = 0.0436).

Conclusions: Permanent LDR prostate implant brachytherapy offers better clinical outcomes than single-fraction HDR for prostate cancer.

Keywords: HDR; LDR; biochemical relapse-free survival; brachytherapy; prostate cancer; relapse.

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References

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