Objective: To investigate the safety and efficacy of low dose rate brachytherapy in local low and intermediate risk prostate cancer patients.
Methods: All 133 local prostate cancer patients were included and divided into low and intermediate risk groups respectively according to Memorial Sloan Kettering Group (MSKG) definition followed by brachytherapy. All the data including prostatic specific antigen (PSA), international prostatic symptomatic score (IPSS), post-operation complications and image evaluation were collected and recorded.
Results: The average radiation dose delivered to 90% of the prostate (D90) of (152.0±17.3) Gy was performed in the patients with a mean pre-operation PSA level of (13.45±7.1) μg/L and prostate volume of (44.37±21.43) mL. Neoadjuvant therapy was performed in 24 patients with prostate volume larger than 60 mL for 3-6 months. There was no difference in the mean age, prostate volume and D90 between low risk group and intermediate risk group. The mean IPSS reached its peak at the end of the 2nd month post-brachytherapy and compared with the baseline at the end of the 4th month. PSA failure occurred at the end of the mean 31.7 months in 4 patients during the follow-up (1 in low risk group and 3 in intermediate risk group) and no metastasis occurred.
Conclusion: Lower urinary tract symptom (LUTS) is the most common complication post-operation. Brachytherapy associates with an encouraging tumor progress-free survival in local low and intermediate risk prostate cancer patients.