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Purpose To analyze the results of exclusive brachytherapy (BT) to treat patients with penile squamous cell carcinoma confined to the glans or prepuce. Methods and Materials Retrospective analysis of 25 patients treated for T1–T2 penile cancer with exclusive interstitial BT between July 1989 and March 2014 at our institution. Results Median followup was 9.2 years (range, 0–19). The mean patient age was 65.3 years (range, 51–80). Most patients underwent exclusive low-dose-rate BT (56%; n = 14) or pulsed-dose-rate BT (40%; n = 10). Only 1 patient received high-dose-rate BT (4%). The median prescribed dose was 60 Gy. Eight patients died during follow-up because of systemic progression (one case) and other intercurrent causes (seven cases). Two failures were recorded (one local and one regional), both at 4 months after BT. The remaining patients continued follow-up at our institution and maintained response. Two patients underwent partial phallectomy for toxicity. At the time of this report, 12 of the 25 patients are alive and free of disease. The most common late toxicities were telangiectasia, urethral stenosis, and atrophy, in 48%, 43%, and 17.4% of patients, respectively. Conclusions BT with low dose rate/pulsed dose rate provides excellent locoregional control for small (≤4 cm) T1–T2 squamous cell carcinoma of the penile glans.

Purpose The objective of this study was to report initial outcomes in patients with locally advanced prostate cancer (CaP) who underwent external beam radiation therapy (EBRT) treatment combined with high-dose-rate brachytherapy (HDR-BT) as a boost. Methods and Materials From 2002 to 2007, 114 CaP patients underwent EBRT followed by 192 I HDR-BT. The patients were classified into intermediate- (Group 1) or high- (Group 2) risk groups. The mean total EBRT dose was 60.0 Gy (95% confidence interval [CI]: 59.9–60.1) at 2 Gy per fraction. After a mean of 20.6 days (95% CI: 18.4–22.8), all the patients received a single-fraction 9-Gy dose of HDR-BT boost. Of the 114 patients in the study, 103 (90.4%) underwent up to 3 years of complete androgen deprivation therapy after diagnosis. Results The mean followup for the entire group was 32.1 months (95% CI: 29.9–34.4). The 4-year biochemical failure-free survival rate was 97.4% and treatment was well-tolerated. Conclusions Preliminary biochemical control rates after EBRT plus one fraction of 9-Gy HDR-BT are encouraging. This atypical fractionation schedule is cost-effective and reduces patient discomfort and treatment-related risks. More followup is required to confirm these findings.

Purpose Few large European studies have evaluated long-term outcomes for permanent prostate brachytherapy (PPB) as monotherapy for clinically localized prostate cancer. The objective of the present study was to evaluate long-term survival in this patient profile. Methods and Materials Retrospective study of 700 patients who underwent transperineal ultrasound-guided iodine-125 PPB (145 Gy) between January 2000 and July 2012. Median age was 64.8 years (range, 35–79). Most patients (638 of 700; 91%) had low-risk disease (D'Amico criteria). Eighty-five patients (12%) received hormonal treatment. Overall survival, cause-specific survival, and biochemical relapse–free survival were calculated and estimated using actuarial and Kaplan–Meier methods. Differences between groups were assessed using the log-rank test. Results Median followup was 63 months (range, 6–164). At 5- and 10-year followup, respectively, overall survival was 94% (95% confidence interval [CI], 92–96) and 84% (95% CI, 78–90); cause-specific survival was 100% and 97% (95% CI, 95–99); and biochemical relapse–free survival was 95% (95% CI, 93–97) and 85% (95% CI, 79–91). Conclusions The long-term results presented in this report confirm previous studies and provide additional support for the use of PPB in patients with favorable-risk prostate cancer. Seed brachytherapy provides excellent long-term results in this patient profile.