High-dose-rate brachytherapy boost to the @entity263 region: hemi-irradiation of XXXX .

@entity1 @entity137 @entity263 @entity5 @entity1315
BACKGROUND: To assess the feasibility, @entity137 , and outcome of prostate hemi-irradiation with a high-dose-rate brachytherapy (HDR-BT) boost for @entity1 presumed to @entity263 in a single lobe. METHODS: After 3D conformal external radiotherapy (3DCRT) to 64-64.4   Gy, 77 @entity1 with non-metastatic locally aggressive @entity263 have been treated from 2000 to 2004, with HDR-BT using temporary open MRI-guided (192) Ir implants, to escalate the dose in the boost region. Twenty @entity1 (26%) had one lobe involvement (i.e., one sided endorectal MRI, rectal examination, and biopsies) and were boosted to one side of the gland only. A dose of 12, 14, and 16   Gy in two fractions was delivered to 5, 6, and 9 @entity1 , respectively. RESULTS: After a median follow-up 69 months, no differences in late rectal @entity137 were observed between the unilaterally and bilaterally irradiated cohorts. Although, grade 2 late urinary @entity137 was worse in the hemi-irradiated group (P = 0.03), severe grade >= 3 late urinary @entity137 at 5 years was not different: 10% versus 8.8% in the unilaterally and bilaterally irradiated cohorts, respectively. Grade 4 late urinary @entity137 , however, was exclusively observed in @entity1 @entity1315 (5/57, 8.8%). Five-year biochemical relapse-free survival was 79.7% versus 70.5% for the unilateral and bilateral boost groups, respectively (P = 0.99). CONCLUSION: Prostate hemi-irradiation with a HDR-BT boost to the dominant @entity5 region may be considered when rectal examination, MRI, and biopsies suggest one lobe involvement. Nevertheless, strict dosimetric optimization is needed in order to further reduce the risk of late severe @entity137 .
