Focal brachytherapy (F-BT) offers a safe and effective treatment for men with low- or intermediate-risk localized prostate cancer (PCa), investigators concluded in a presentation at the European Association of Urology 2020 virtual congress.
The procedures involves implanting seeds in a target area accurately identified as harboring PCa.
Igor Nunes-Silva, MD, of Arnaldo Vieira De Carvalho Cancer Institute in São Paulo, Brazil, and colleagues described their experience with 39 patients who underwent primary F-BT. Of these, 35 had low-risk and 4 had intermediate-risk PCa. Patients had cT2a or less disease, PSA levels below 15 ng/mL, and a magnetic resonance imaging focus PIRADS score of 4-5. Seeds were implanted in the target zone (index lesion) with 1 cm of safety margin within the normal ipsilateral prostatic parenchyma, they explained. The dose prescription was 145 Gy to the target zone. The presence of any residual PCa in the treated area was considered treatment failure.
After a 2-year follow-up, 34 patients had a systematic control biopsy. This biopsy was negative in the treated zone in 32 cases (94%). It was positive in-field in 2 cases (5.8%) and outside the field in 6 cases (17.6%), according to the investigators.
The 8-year overall and disease-free survival were 100% and 81.5%, respectively. F-BT was not associated with sexual or rectal toxicity, Dr Nunes-Silva and colleagues reported.
The overall mean International Prostate Symptom Score at 2 months was significantly elevated compared with baseline (12.52 vs 6.69), but the investigators observed no significant differences in score during subsequent postoperative months.
Nunes-Silva I, Ta MH, Barret E, et al. Focal brachytherapy for localized prostate cancer: Mid-term outcomes. Presented at: EAU20 Virtual Congress; July 17 to 19, 2020. Abstract 390.