LDR vs. HDR Brachytherapy for Prostate Cancer

Inclusion Criteria:

Favorable risk and low-tier intermediate-risk prostate cancer with estimated life expectancy of at least 10 years.

• Clinical stage T1c-T2b, PSA < 20, Gleason < 8

• ECOG 0-1

• Low tier intermediate-risk prostate cancer is defined by a single NCCN intermediaterisk factor

• Extensive favorable-risk disease is defined as:

• clinical stage T1c-T2a

• PSA < 10

• Gleason 6

• ≥ 50% of biopsy cores containing cancer

• PSA density > 0.2 ng/cc

• Selected intermediate risk patients not defined above

• T1c/T2a

• PSA < 10

• -Gleason 4+3

• -< 33% of cores involved

• -Max tumor length in any core 10 mm

• No androgen deprivation therapy (ADT)

• Prostate volume by TRUS ≤ 60 cc.

• Not eligible for, or accepting of, active surveillance according to NCCN guidelines.

• Signed study specific informed consent.

Exclusion Criteria:

• Prior radical surgery for carcinoma of the prostate,

• Prior pelvic radiation

• Prior chemotherapy for prostate cancer,

• Prior TURP or cryosurgery of the prostate

• Claustrophobic or unable to undergo MRI