Improving Quality of Life After Prostate Brachytherapy: a Comparison of HDR and LDR Brachytherapy

Optimal non surgical treatment of prostate cancer requires dose escalation which is frequently provided by adding a brachytherapy "boost" to a short course of external beam radiotherapy. The hypothesis in this randomized study is that a High Dose Rate (HDR) brachytherapy boost leads to equivalent or better Prostate Specific Antigen (PSA) recurrence-free survival when compared to a Low Dose Rate (LDR) brachytherapy boost and that it is associated with a more favorable toxicity profile and improved quality of life.

Sex

Male

Minimum age

45 Years

Maximum age

80 Years

Inclusion Criteria:

* Upper tier intermediate risk with at least 2 of the following factors

  1. Tumor-Nodes-Metastases Tumor stage T2B or greater
  2. Gleason Score 7
  3. PSA \> 10
  4. \> 50% of the biopsies positive
* OR High risk prostate cancer with one of the following factors

  1. T3a
  2. Gleason Score8-10
  3. PSA \>20
* Positive prostate biopsy within 12 months (reviewed centrally)
* International Prostate Symptom Score \< 16
* Prostate volume \< 60 cc
* Negative staging CT and Bone scan within 3 months prior to registration
* History and physical examination within 90 days prior to registration
* European Cooperative Oncology Group performance status 0-1 prior to registration
* Age \>45
* Patient suitable for procedure under anesthesia

Exclusion Criteria:

* Prior invasive malignancy (except non melanoma skin cancer) unless disease-free for at least 3 years prior to registration
* Previous prostatectomy, cryotherapy or High Intensity Focussed Ultrasound for prostate cancer
* Previous pelvic irradiation or prostate brachytherapy

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