Abstract
Background and purpose
To demonstrate the feasibility, safety and effectiveness of dose escalation to intraprostatic
lesions with MRI-transrectal ultrasound fusion High-Dose-Rate (HDR) brachytherapy.
Materials and methods
15 patients with intermediate-high risk prostate cancer and visible dominant intra-prostatic
nodule on mpMRI have been treated. The treatment consisted of combined MRI-TRUS fusion
HDR-brachytherapy (1 fraction of 1500 cGy) and hypofractionated external beam (3750 cGy in 15 fractions).
A dose of 1875 Gy was delivered to at least 98% of the DIL volume.
Results
Median prostate volume was 23.8 cc; median number of needles was 16 (13–18). Dose escalation to DIL was feasible in
14/15 patients (93%) without violating dosimetric constraints and 1 patient presented
a minimal deviation of dosimetric restrictions.
With a median follow-up of 18 months (17–24), none of the patients developed acute urinary retention or grade ⩾3
toxicity.
In addition to standard PSA follow-up, response has been assessed by mpMRI at 12 months. All patients presented adequate morphological responses on anatomical and
functional sequences.
Conclusions
HDR brachytherapy using MRI-transrectal ultrasound fusion for image guidance is a
suitable technique for partial prostate dose escalation. Tolerance and toxicity profiles
are excellent and results are encouraging in terms of biochemical, morphological and
functional response.
Keywords
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Article info
Publication history
Published online: February 15, 2016
Accepted:
February 1,
2016
Received in revised form:
February 1,
2016
Received:
December 11,
2015
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
