Low dose rate brachytherapy in low and middle risk prostate cancer: Results and impact on quality of life with 5 year follow up

Abstract

Low dose rate brachytherapy (LDR-Br) with radioactive isotopes is a curative treatment and has shown to be comparable for the management of localized prostate cancer (PCa) to more conventional treatments such as radical prostatectomy or external beam radiotherapy, but with fewer side effects.

The aim of this study is to show the global, specific and biochemical recurrence-free survival in 193 patients undergoing low dose rate Brachytherapy with permanent implants with iodine 125 and analyze the quality of life impact.

193 patients with localized PCa were consecutively treated over a period of 10 years (2005-2015). All of them were followed up on levels of prostate specific antigen (PSA) and 68 of them completed a quality of life survey.

The average age was 62.8 years and the average PSA was 6.4 ng/dl at the time of Br. 29.5% of patients were classified as intermediate risk, with a Gleason score sum of 7 and/or a PSA between 10 and 20 ng/dl. Mean follow-up was 64.2 months; overall, specific and biochemical recurrence-free survival were 92.8%, 99.0% and 90.2% respectively. The most significant changes in the quality of life recorded were urinary incontinence, urinary and bowel irritative symptoms, in the first 6 months after brachytherapy. Sexual function shows significant changes but all with favorable response using phosphodiesterase inhibitors.

This series of patients with PCa shows similar biochemical free survival rates BFSR in low risk patients to external beam radiotherapy and radical prostatectomy, but better BFSR in intermediate risk patients. The impact in the quality of life was significant in urinary incontinence, urinary irritate symptoms, and sexual function, but they were transitory with the exception of sexual function