Results

In our Centre a total of 70 patients have been treated with this technique and is the first in the medical literature using in patients with favorable risk prostate cancer. Our technique has the great advantage of being practically a one-time procedure which prevents any movement of the needles.

In our series acute and late genitourinary toxicity grade 2 or more was not observed in any patient. The median of flow rate test pretreatment in our study was 12.5 ml/s (3-30 ml/s) but acute urinary retention was seen in only 1 patient, requiring a temporary postimplant bladder catheter during seven days, this results are better than other investigators [13-16].

The lasted follow-up visit the sexual preservation rate was 89% in patients who were potent preoperatively and not receiving hormonal therapy, this result is similar to that other investigators.

The late grade I genitourinary toxicity caused by our treatment was significantly associated with the dose administered to the PTV represented by D90 (p=0.050).

In our study no gastrointestinal toxicity, such as anal pain, rectal bleeding, diarrhea, anal ulcer and/or rectourethral fistula has been observed after treatment. We believe that the increase in distance between rectum and posterior prostatic capsule created by the peri-rectal injection of hyaluronic acid is enough to provide a significant radiation dose reduction from HDR brachytherapy and have significantly smaller incidence of mucosal damage [11, 12].

The actuarial biochemical control in our series was 100% and 88% respectively for low and intermediate risk groups at 32 months, but is too early to draw final conclusion respect to biochemical control.

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