ESTRO 2022 - Abstract Book

S1618

Abstract book

ESTRO 2022

Materials and Methods Our series included patients with histopathological confirmation of local relapse prostate cancer. All patients also had an MRI or PET image that confirmed local recurrence only. All patients received HDR brachytherapy in two implants, 15 days apart. Each implant consisted of 2 fractions of 8 Gy BID, for 32 Gy total dose. Procedure was performed with real-time ultrasound image guidance (Oncentra Prostate treatment). Clinical variables (diagnosis risk group, primary treatment, biochemical failure PSA levels, MRI/PET-CT and histological findings, actual clinical status) was collected. Data was analyzed using SPSS´s multivariate analysis, and Kaplan-Meier to estimate survival rates. Results From 34 patients studied, 27 (81.4%) were categorized at first diagnosis as Gleason 6, four as Gleason 7 (11.7%), one as Gleason 8 (2,9%), and one as Gleason 9 (2,9%).The time between diagnosis and recurrence had a median of 66.5 months (range 16-221 months). The median PSA at the time of biochemical failure was 4.16 ng / ml (range 1.9-31.6 ng/ml). Among those 34 patients confirmed as local relapse prostate cancer after external radiotherapy or LDR brachytherapy, and treated with HDR brachytherapy, there have been six events of local recurrence after salvage. 4 patients are alive with disease (in active treatment), and 2 have died with disease. Follow-up of the series has a median follow-up of 48 months, with a range of 4 to 119 months. Our series showed 67,8% 5 years biochemical failure free survival rate, and 94,1% 5 years specific cause overall survival. Conclusion In our study, there was significative and relevant free-relapse survival and specific-cause overall survival rates in local relapse prostate cancer patients treated with HDR brachytherapy. Free-relapse survival and specific-cause overall survival rates from our series are similar to those observed in different trials and shown by meta-analysis. N. Hayakawa 1 , R. Mizuno 2 , Y. Shiraishi 3 , T. Tanaka 3 , K. Matsumoto 2 , T. Kosaka 2 , T. Ohashi 3 , E. Kikuchi 4 , N. Shigematsu 5 , M. Oya 2 1 St. Marianna University School of Medicine, Urology, Kanagawa, Japan; 2 Keio University School of Medicine, Urology, Tokyo, Japan; 3 Keio University School of Medicine, Radiology, Tokyo, Japan; 4 St. Marianna University School of Japan, Urology, Kanagawa, Japan; 5 Keio University School of Medicine, Radiology, Kanagawa, Japan Purpose or Objective We assess prospectively the efficacy of tadalafil for urinary and sexual dysfunction after prostate brachytherapy (PB) compared with tamsulosin hydrochloride in the patients treated with PB for localized prostate cancer. Materials and Methods Overall 111 patients treated with PB were randomized into two groups of either those treated with daily use of 0.2mg of tamsulosin hydrochloride (N=56, Tam group) or 5mg of tadalafil (N=55, Tad group) just after PB. Sexual and erectile function were assessed before PB (baseline), and 1, 3, 6, 12 months postoperatively using International Index of Erectile Function- 15 (IIEF-15) and Erection Hardness Score (EHS). We also assessed urinary function using questionnaires of International Prostate Symptom Score (IPSS) and Over Active Bladder Symptom Score (OABSS). Results Mean±SD of baseline IIEF-15 score, EHS, IPSS and OABSS were 26.0±20.4, 2.2±1.5, 7.9±6.1 and 3.3±2.7 in Tad group and 21.0±17.9, 1.9±1.6, 7.7±5.9 and 3.4±2.2 in Tam group respectively, with no significant difference. Mean±SD of IIEF-15 and EHS 1,3,6,12 months after PB were 17.0±14.1, 23.3±18,8, 23.6±18.9, 25.3±21.6 and 1.9±1.6, 2.3±1.4, 2.2±1.5, 2.3±1.4 in Tad group, and 14.7±10.9, 15.7±13.2, 17.2±12.6, 19.2±14.0 and 1.3±1.5, 1.4±1.4, 1.4±1.3, 1.6±1.3 in Tam group. IIEF-15 score were significantly decreased in both groups at a month. after PB compared with the baseline (Tam group: p=0.001 Tad group: p<0.001). It was improved to a level not significantly different from the baseline (baseline level) at 3 months in the Tad group and at 6 months in the Tam group. EHS was significantly decreased at the 1, 3, 6 months after PB compared with the baseline (p=0.013, p=0.039, p=0.002, respectively) and it was improved to baseline level at 12 months, in the Tam group. In contrast, it was not significant difference between baseline and 1, 3, 6, 12 months after PB in Tad group. Comparing of two groups, IIEF-15 score was significantly lower in Tam group than in Tad group at 3 months only (p=0.011). On the other hand, EHS was significantly lower in the Tam group than in Tad group at 1, 3, 6, 12 months (p=0.046, p=0.002, p=0.007, p=0.019, respectively). Mean±SD of IPSS and OABSS 1, 3, 6, 12 months after PB were 17.4±9.2, 17.0±8.8, 14.9±8.9 and 9.6±6.8 6.6±3.9, 7.1±3.6, 5.8±3.4, 4.1±2.6 in Tad group, and 16.1±8.5, 15.6±8.2, 13.0±7.2, 9.1±6.6 and 6.0±3.3, 6.0±3.1, 5.1±2.7, 3.7±2.4 in Tam group. They were significantly higher in both groups at the 1, 3, 6 months after PB compared with the baseline (Tad group: IPSS; all p<0.001, OABSS; all p<0.001, Tam group: IPSS; p=0.001, p<0.001, p<0.001, OABSS; all p<0.001, respectively). They were improved to baseline level only in Tam group at 12 months. There were no significant differences between two groups at the 1, 3, 6,12 months. Conclusion Findings indicate a global decrease in sexual and urinary function status after PB even using tamsulosin hydrochloride and tadalafil. Erectile function might be preserved by tadalafil treatment. PO-1818 Prospective study of tadalafil treatment in patients treated with prostate brachytherapy in Japan.

PO-1819 partial brachytherapy in prostate cancer phantoms with and without rectum spacer