High-dose-rate interstitial brachytherapy as monotherapy in one fraction and transperineal hyaluronic acid injection into the perirectal fat for the treatment of favorable stage prostate cancer: treatment description and preliminary results

All patients tolerated the implantation procedure very well with minimal discomfort. No intraoperative or perioperative complications occurred. Acute toxicity Grade 2 or more was not observed in any patients. No chronic toxicity has been observed after treatment. Logistic regression showed that the late Grade 1 GU toxicity was associated with D(90) (p=0.050). The 32-month actuarial biochemical control was 100% and 88%, respectively (p=0.06) for low- and intermediate-risk groups. This is the first published report of the use of HDR brachytherapy as monotherapy in one fraction for patients with favorable-risk prostate cancer. This protocol is feasible and very well tolerated with low GU morbidity, no gastrointestinal toxicity, and the same level of low-dose-rate biochemical control at 32 months.