Long-term outcomes of ultra-hypofractionated 2 fractions single day HDR brachytherapy in localized prostate cancer

Introduction and objectives: We previously published the toxicity and initial results of a prospective cohort of patients treated with 2 fractions HDR-BRT administered in a single day. In the present analysis we report the long-term cancer control results of our prospective trial and investigate the relationship between PSA nadir and biochemical control. Material and methods: A total of 120 patients were treated with HDR Brachytherapy monotherapy administered in two fractions in a single day. Between November 2010 and February 2016, 84 patients with low-risk and 36 patients with intermediate-risk prostate cancer in accordance with the NCCN practice guidelines. Results: Median age was 66 years (range 45-84) and median PSA was 7.5 ng/ml (range 0.01-16 ng/ml). Overall, 84.2% had Gleason score 6 and 15.8% Gleason 7. Thirty-one percent of patients received ADT.After a median follow-up of the cohort was 123 months. Actuarial rates of no biochemical evidence of disease (bNED), overall survival, local control and metastasis-free survival for all patients were 93.3%, 86.7%, 95.2% and 96.1%, respectively.The median time to achieve PSA nadir was 80.5 months. Patients who attained a PSA Nadir & LE; 0.20 ng/mL exhibited a 10-year bNED survival rate of 96.9%, whereas thosewho failed to reach this PSA level had a survival rate of only 40%. Conclusions: In patients with favorable localized prostate cancer, 2 fractions HDR-BT monotherapy is a highly curative radiation technique that attains PSA nadir levels < 0.2 ng/mL in 95% of cases. & COPY; 2023 Elsevier B.V. All rights reserved. Radiotherapy and Oncology 186 (2023) 1-7

Automated summary

In this prospective cohort study, we demonstrate the long-term cancer control results of two fractions HDR-BRT administered in a single day and investigate the relationship between PSA nadir and biochemical control. Our findings show that HDR-BT monotherapy is highly effective in achieving curative outcomes for patients with favorable localized prostate cancer.