The aim of our work was to evaluate how HDR brachytherapy is tolerated among men older than 75 and how associated diseases can influence the tolerance to this treatment. Of interest to us were the treatment results and mortality from other diseases.
We analyzed a sample of 20 men above 75 years old (median 77 years) who were undergoing treatment by a combination of external radiotherapy and brachytherapy. Sixteen (80 % ) of them had prostate cancer with an intermediate and high risk of recurrence, four had low risk prostate cancer. Most patients, 14 (70 % ), had less than two comorbidities.
The median observation period was 57 months. No perioperative complications were recorded. Acute genitourinary toxicity (GU) to a maximum grade of 1-2 manifested in 60 % of cases. Acute gastrointestinal toxicity (GIT) was observed only at grade 1 and in 25 % of cases. Late GU toxicity occurred in 35 % of patients, with only one showing grade 3; late GIT toxicity was recorded at grade 1 only in 3 patients (15 % ). 70 % of the men lived longer than 3 years after treatment, at present, 50 % lived more than 5 years. Long-term biochemical remission was achieved in 18 patients (90 % ).
HDR BRT is possible and well-tolerated in older men above 75 years in good condition and without serious intercurrence.
Well-selected older patients with higher-risk tumours and without serious comorbidities undoubtedly benefit from radical treatment when compared with watchful waiting.