Risk factors for the development of prostate brachytherapy related XXXX .

@entity1 @entity263 @entity5 @entity3832 @entity342 @entity850
PURPOSE: We identified clinical, treatment and dosimetric parameters associated with the development of @entity3832 following permanent prostate brachytherapy. MATERIALS AND METHODS: From April 1995 through April 2003, 1,186 consecutive @entity1 underwent prostate brachytherapy for clinical stage T1b-T3a NxM0 (2002 American Joint Committee on @entity5 ) @entity263 . The treatment plan included supplemental XRT in 625 @entity1 (52.7%) and @entity342 deprivation therapy in 465 (39.2%). Median followup was 4.3 years. Multiple clinical, treatment and dosimetric parameters were evaluated in univariate and multivariate analyses to identify independent predictors for @entity3832 . RESULTS: A total of 29 @entity1 had brachytherapy related @entity3832 . All strictures involved the BM urethra with a 9-year actuarial risk of 3.6% and a median time to development of 2.4 years. The mean radiation dose to the BM urethra was significantly greater in @entity1 with vs without stricture (p = 0.002). On multivariate analysis the BM urethral dose and supplemental XRT predicted @entity3832 . All except 3 @entity1 were successfully treated with urethral dilation or internal optical urethrotomy. CONCLUSIONS: Brachytherapy related @entity3832 correlates highly with the radiation dose to the BM urethra. Careful attention to brachytherapy preplanning and intraoperative execution along with the judicious use of supplemental XRT is essential to minimize the incidence of @entity850 .
