High Dose Rate Brachytherapy

Recently we reviewed a group of patients that I had treated between 1998 and 2000. We followed the patients up for a minimum of 10 years and compared it to a similar surgical series. Results were outstanding and in truth out-performed my surgical results in the very high-risk population by about 20% ( these results will shortly be the subject of a publication). It is worth noting, however, that surgery with follow up radiotherapy is challenging these results (see graph below).

Results of HDR

Generally, the cure-rate for high-dose rate brachytherapy in combination with external beam radiotherapy depends on how many high-risk factors ( Gleeson score 8-10 , PSA >20 , Clinical stage T3 )are involved. If there is:

  • One risk factor - 90% 10-year cure rate
  • Two risk factors - 70% Cure rate
  • Three risk factors - 60% Cure rate
  • Impotence - 50%
  • Incontinence - 1%
  • Rectal damage - <1%
  • Urethral stricture rate- 5%

Once again, high-dose brachytherapy is generally reserved for those patients with extremely extensive prostate cancer where surgical cure is difficult, particularly in more middle-aged and older patients, where urinary symptoms are not dominant and where there is a dominance of apical disease or where I am concerned that the cancer is not resectable.

 

Key aspects

From diagnosis and treatment to rehabilitation and research, I believe my highly experienced team and I bring a multifaceted approach to understanding and helping our patients. A summary of these key aspects of that approach is available here in PDF format. If you are suffering from prostate cancer or have reason to believe you might be, you are welcome to contact us or, intially, complete our comprehensive second opinion form.