Feasibility of MRI targeted single fraction HDR brachytherapy for localized prostate carcinoma: ProFocAL-study

J Cancer Res Clin Oncol. 2023 Jul;149(8):5397-5404. doi: 10.1007/s00432-022-04491-3. Epub 2022 Nov 29.

Abstract

Purpose: A potential method for focal therapy in locally advanced prostate cancer is focal brachytherapy (F-BT). The purpose of this research was to evaluate midterm F-BT oncologic, functional, and toxicological results in men who had therapy for prostate cancer.

Materials and methods: Between 2016 and 2020, F-BT was used to treat 37 patients with low- to intermediate-risk prostate cancer. The recommended dosage was 20 Gy. Failure was defined as the existence of any prostate cancer that has persisted in-field after treatment. The F-BT oncologic and functional outcomes served as the main and secondary objectives, respectively.

Results: A median 20-month follow-up (range 14-48 months). 37 patients received F-BT and enrolled in the study; no patient experienced a biochemical recurrence in the first 24 months, according to Phoenix criteria. In the control biopsies, only 6 patients showed in-field failure. The median initial IPSS was 6.5, at 6 months was 6.0, and at 24 months was 5.0. When the median ICIQ-SF score was 0 at the baseline, it remained 0 at 6-, 12-, and 24 months. Overall survival and biochemical disease-free survival after 3 years were all at 100% and 86.4%, respectively. There was no notable acute gastro-intestinal (GI) or genitourinary (GU) adverse effects. No intraoperative or perioperative complications occurred.

Conclusions: For selected patients with low- or intermediate-risk localized prostate cancer, F-BT is a safe and effective therapy.

Keywords: Biochemical failure; Brachytherapy; Focal therapy; MRI; Prostate cancer.

MeSH terms

  • Brachytherapy* / methods
  • Feasibility Studies
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Prostate / pathology
  • Prostate-Specific Antigen
  • Prostatic Neoplasms*
  • Radiotherapy Dosage

Substances

  • Prostate-Specific Antigen