High and intermediate XXXX treated with three-dimensional computed tomography-guided brachytherapy: 2-8-year follow-up.

@entity1 @entity263 @entity342 @entity322
PURPOSE: To report post-brachytherapy results in high and intermediate risk @entity1 of @entity263 . METHODS AND MATERIALS: From June 1994 to June 2000, 356 consecutive high and intermediate risk @entity1 were treated with three-dimensional computed tomography-guided stereotactic pararectal brachytherapy. The age was 42-90 years (median, 68 years), the initial prostate volume was 14-180 cm3 (median, 59 cm3), and initial PSA was 1.7-143 ng/ml (median, 10.5 ng/ml). Three hundred forty-eight @entity1 were available for follow-up for 2-8 years (median, 4.5 years). Two hundred eighty @entity1 had one or more high risk factors (PSA >20 ng/ml, Gleason>7, Stage T2b, T3a, or T3b). Sixty-eight @entity1 had only one intermediate risk factor (PSA 10-20 ng/ml or Gleason=7). @entity1 with both intermediate risks were considered high risk. The high-risk group was further stratified into subgroups with similar risk profile. A dose of 144 Gy with 125I or 120 Gy with 103Pd was achieved in 90-100% of the target. Thirty (30) @entity1 (9%) had prior transurethral resection and 229 (64%) were treated with 3 months neoadjuvant @entity342 ablation. RESULTS: Biochemical disease-free survival was 92% of 280 high risk @entity1 and 96% of 68 intermediate risk @entity1 . Seven @entity1 (2%) required catheterization during the first year for urinary retention, nine @entity1 (3%) required TUR 1-3 years post-implant, three @entity1 (1%) developed grade 1 or 2 @entity322 after a second TUR, and four @entity1 (1%) developed grade 3 rectal complications. CONCLUSION: This method produces a high level of biochemical control 2-8 years (median 4.5 years). Morbidity is acceptable regardless of risk profile or initial prostate volume.
