The results of Iridium192 high-dose rate brachytherapy application combined with distant radiotherapy in patients with seminal vesicle invasion prostate cancer

Solodkiy V.A., Pavlov A.Yu., Cybul'skiy A.D., Garmash S.V., Ivashin A.K., Isaev T.K.

Introduction. Among contemporary radiotherapeutic methods, brachytherapy is regarded as the most effective and safe method of radiation dose delivery in comparison with 3D-conformal radiation therapy. Despite this fact, according to many European guidelines on prostate cancer treatment, brachytherapy is not considered as a possible approach to the treatment of locally advanced prostate cancer but is included in the group of methods of treatment which are applied only in the low-risk group.

Aim. To evaluate the clinical results of treatment of patients with seminal vesicle invasion prostate cancer, who have received complex treatment of Iridium192 high-dose rate brachytherapy combined with distant radiotherapy and androgen deprivation therapy.

Materials and methods. The study included 39 high-risk patients with seminal vesicle invasion prostate cancer without any features of distant metastasis. In the first part of radiation therapy, the patients received Iridium192 brachytherapy, with 10 Gy delivered in one fraction. Two weeks later, the patients underwent distant radiotherapy (44-46 Gy standard fractionation for prostate and regional lymph outflow).

Conclusion. Non-recurrent, PSA-specific survival rate was 87%; the median duration of monitoring was 42 months. Only in 2 (5,2%) cases cancer recurrence was observed. Erectile function (EF) analysis demonstrated that among 20 patients, who were interested in being sexually active a?er receiving complex therapy, 11 of them did not lose their EF. No late radiation-related adverse effects (III and IV stages) were observed.

Authors declarelack of the possibleconflicts of interests.

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brachytherapy, high-dose-rate intensity-modulated brachytherapy, iridium, prostate cancer