ArticleAdvances in radiation oncology2025
High-Dose-Rate Brachytherapy Boost for Prostate Cancer: A Retrospective Observational Study in Low- and Middle-Income Countries.
Article in Advances in radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Prostate brachytherapy used as an adjunct to external beam radiation therapy is recognized as an effective therapeutic approach in the treatment of intermediate and high-risk prostate cancer. However, data remain limited in African countries, particularly Morocco. The aim of this study was to assess the oncological outcomes and tolerability of boost brachytherapy in a Moroccan cohort. Methods and Materials: A retrospective study was conducted between 2014 and 2022. Among 128 patients treated with prostate brachytherapy, 106 with intermediate- or high-risk prostate cancer who received high-dose-rate brachytherapy as a boost were included. Hormone therapy was administered to 84.91% of patients. Median follow-up was 26 months. Clinical characteristics, dosimetric data, toxicity, and oncological results were analyzed. Results: Of the 106 patients, 59 (55.66%) had intermediate-risk cancer and 47 (44.34%) had high-risk cancer. Locally advanced stage (T3a-T3b) was observed in 43.4% of patients. At 3 years, overall survival, metastasis-free survival (MFS), and biochemical progression-free survival (BPFS) were 87%, 92%, and 78%, respectively. The 3-year BPFS was 75% for intermediate-risk cancers and 70% for high-risk cancers. International Society of Urological Pathology (ISUP)scores 1 to 3 showed better BPFS (85%) and MFS (92%) than ISUP scores 4 to 5 (BPFS: 60%, MFS: 79%). Clinical stage was the only significant factor for MFS ( Conclusions: This single-center study confirms the efficacy and tolerability of the combination of external beam radiation therapy and brachytherapy in the treatment of intermediate- and high-risk prostate cancer. The results are encouraging, even in advanced-stage patients. Clinical stage has been shown to be the main prognostic factor for MFS.
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