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The aim of this study was to investigate disease-free sur- vival and toxicity of high-dose rate brachytherapy (HDR-BT) in patients with prostate cancer at low risk of progression in monotherapy. With the use of advanced methods of imaging and planning brachytherapy allows achieving a high accuracy of radiotherapy delivering the adequate dose to the prostate and in the same time minimizing the toxic effects from adjacent organs. Brachytherapy by Ir-192 was carried out in 20 patients, in the form of monotherapy 3 fractions in a single focal dose 10 Gy with a two-week interruption between fractions to a total focal dose 30 Gy. Biologically effective dose was 230 Gy. The percentage of the prescribed dose on organ-target (V100) was not less than 95% (average 97.1 %). The critical dose on the urethra and the rectum was 110% and 70% of the prescribed dose respectively. The early and late radiation toxic reactions from genitourinary system and gastrointestinal tract in all of them were marked only as I grade. There were no adverse events of II-IV grades. Therefore HDR-BT as monotherapy has proved to be a safe and effective method of treatment prostate cancer patients of low risk of progression. Disease-free 5-year survival was 100% while minimizing toxic reactions from adjacent organs.

To relieve pain associated with multiple bone metastases radiopharmaceutical method of treatment is of great importance--the use of beta-emission isotope of strontium chloride-89 (metastron). Passing through the human skeletal system, strontium-89 accumulates in areas of high mineral density, which is it typical for osteoblastic metastases. In our institution in the frames of a randomized trial in 90 patients with metastatic hormone-resistant prostate cancer it was carried out systemic radiotherapy with strontium-89 chloride as a stage of complex treatment. Stabilization of pain syndrome during treatment was 72,7% and its progression was noted in 27,3% cases. Radiopharmaceutical therapy is well tolerated and can be used as a stage in complex treatment of patients with hormone-resistant prostate cancer.

Treatment for prostate cancer remains a significant social problem due to the continuing trend of growth of morbidity and mortality in Russia from this disease. In recent years a real alternative to surgical treatment is radiotherapy. In treatment of locally advanced stages of prostate cancer radiotherapy plays a dominant role. At our institution from 2005 till 2011, 105 patients with locally advanced prostate cancer underwent complex and combined treatment comprising in the first group the concomitant radiotherapy with Ir-192 and the control group--radical prostatectomy followed by adjuvant remote radiotherapy. In patients treated with concomitant radiotherapy compared to the control group there were occurred fewer number of genitourinary complications according to the RTOG scale (5,8% vs. 32,7%). In patients who had undergone radical prostatectomy followed by adjuvant radiotherapy urinary incontinence was met significantly often.