ASCO GU 2008 - Brachytherapy: More Is Better

UroToday.com - A survey in 2002 reported that half of urologists in the US offer brachytherapy. The concept of radiation guidance can be either giving radiotherapy via beam or needles. He argued that prostate IG-HDR delivers high doses to the prostate and not the rectum or urethra. He presented a 5-week hyperfractionated protocol of EBRT and HDR boost. The 5-year outcomes of 267 patients treated with high doses revealed the biochemical control is 90%, compared to 68.7% for low dose. Overall survival at 5 years was better with the high dose combination. The mean dose delivered is 77Gy in the ART group which is higher than the 68Gy in the ERBT group. The HDR prostate bed dose was biologically much higher. Patients receiving HDR boost do better regarding 10 survival results with 76% having biochemical freedom from disease. The distant metastatic rate of HDR is also less than ERBT + ART.

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