Abstract :
Keywords: prostate cancer; low-dose-rate brachytherapy; long-term outcomes; bladder neck incision; urinary incontinence; urethral stricture Objectives To examine the long-term oncological outcomes and urological morbidity of low-dose-rate prostate brachytherapy (LDRBT) monotherapy using live intraoperative dosimetry planning and an automated needle navigation delivery system for the treatment of men with low and intermediate-risk prostate cancer. Patients and Methods A prospective database of 400 consecutive patients who underwent LDRBT between July 2003 and June 2015 was retrospectively reviewed to assess urinary side-effects and biochemical progression, based on the Phoenix definition and also a definition of a prostate-specific antigen (PSA) level of â¥0.2[MU]g/L. Results Minimum patient follow-up was 5.5years. The median follow-up of the entire cohort was 11.8years. The median (range) PSA level was 6.1(0.9-17)[MU]g/L and the median Gleason score was 3+4. The biochemical relapse-free survival (RFS; freedom from biochemical recurrence) based on the Phoenix definition was 85.8% (343/400). The RFS using a 'surgical' definition of a PSA level of Conclusion LDRBT is associated with excellent PCSS, with a median follow-up of 11.8years. The risk of post-implantation urethral stricture and UI is low and a pre-implantation BNI for management of bladder outflow obstruction does not increase the risk of UI or urethral stricture. Byline: William John Yaxley, James Mackean, Devang J. Desai, Gail Tsang, Judi Dixon, Hemamali Samaratunga, Brett Delahunt, Lars Egevad, Robert A. Gardiner, John William Yaxley