Objective:Low Dose Rate Brachytherapy (LDR-BT) in localized prostate cancer is available since 15 years in Italy. We realized the first national multicentre and multidisciplinary data collection to evaluate LDR-BT practice, given as monotherapy, and outcome in terms of biochemical failure.Methods:Between 5/1998 and 12/2011, 2237 early stage prostate cancer patients from 11 Italian Community and Academic Hospitals were treated with Iodine-125 (125I) or Palladium-103 (103Pd) LDR-BT as monotherapy and followed-up for at least two years. 125I seeds were implanted in 97.7% of the patients: the mean dose received by 90% of target volume (D90) was 145 Gy; the mean V100 (target volume receiving 100% of prescribed dose) equals 91.1%. Biochemical failure free survival (BFFS), Disease specific survival (DSS) and Overall Survival (OS) were estimated using Kaplan-Meier method. Log-Rank test and multivariable Cox regression were used to evaluate relationship of covariates with outcomes.Results:Median follow-up time was...

Objective: To evaluate toxicity and clinical outcome in synchronous bone only oligometastatic (≤2 lesions) prostate cancer patients, simultaneously irradiated to prostate/prostatic bed, lymph nodes and bone metastases. Methods: From 2/2009 to 6/2015, 39 bone only prostate cancer patients underwent radiotherapy (RT) at “radical” doses to bone metastases (median 2 Gy equivalent dose, EQD2>40Gy, α/β = 1,5), nodes, and prostate/prostatic bed, within the same RT course, in association with androgen deprivation therapy (ADT). Biochemical relapse-free survival, clinical relapse-free survival, freedom from distant metastases and overall survival were evaluated. Results: After a median follow-up of 46.5 (1.2–103.6) months, 5 patients died from disease progression, 10 experienced biochemical relapse, 19, still in ADT, presented undetectable prostate-specific antigen (PSA) at the last follow-up. Five patients who discontinued ADT after a median of 34 months (5.8–41) are free from biochemical relapse. The 4 year Kaplan–Meier estimates of biochemical relapse-free survival, clinical relapse-free survival, freedom from distant metastases and overall survival were 53.3%, 65.7%, 73.4% and 82.4% respectively. No Grade > 2 acute events and only two severe late urinary events were recorded, not due to the concomitant treatment of primary and metastatic disease. Conclusion: Our results suggest that “radical” and synchronous irradiation of primitive tumor and metastatic disease may be a valid approach in synchronous bone only prostate cancer patients, showing mild toxicity profile and promising survival results. Advances in knowledge: To the best of our knowledge, this is the first analysis of clinical outcome in synchronous bone-only metastasis (neither nodal nor visceral) patients at diagnosis, treated with radical RT to all disease, associated to ADT.