Headline: Low- versus high-dose rate brachytherapy boost during definitive prostate radiation results in slower recovery from acute toxicities.
The Study: Have you ever wondered if the difference in brachy techniques affects anything but logistics? This phase.3 trial is here with answers. 191 men receiving external beam to 46 Gy in 23 fractions to the whole pelvis for intermediate (42%) to high risk (58%) prostate cancer were randomized to low- (110 Gy) versus high-dose (15 Gy) rate brachy boost to the prostate. HDR was done prior to EBRT while LDR was done after. Men receiving high-dose rate brachy had worse urinary scores at one month but better urinary and bowel scores at 3 and 6 months. What’s more, better bowel scores were maintained out to 4 years.
TBL: Per the authors, “the patient experience of combined external beam radiation and brachy boost to the prostate is improved with HDR." | Moideen, ASTRO 2022