Potency pReservation In Prostate cAncer Patients Treated With UltraSound-guided Low-dose Rate Brachytherapy

Participation Requirements

• Sex:

  MALE

• Eligible Ages:

  18 to 75

Participation Criteria

Inclusion Criteria:

* Biopsy-confirmed adenocarcinoma of the prostate
* NCCN-defined low- or favourable intermediate-risk prostate cancer patients
* All pathological cores confined to one lobe of the prostate (minimum of 12 cores sampled), unless a recent multiparametric prostate MR-scan (mpMR) (with \< 6 months from the enrollment date) indicates a dominant intra-prostatic lesion (DIL) located at the prostatic lobe where a higher number of cores and Gleason score was found positive. PIRADS v2 score 3-5 lesions are considered DILs.
* No or mild erectile function impairment (score ≥18 in International Index of Erectile Function- 5 \[IIEF-5\] without PDE-5 inhibitor assistance)
* Sexually active
* No contraindications to prostate LDR brachytherapy

Exclusion Criteria:

* Core positivity in both lobes of the prostate with no DIL detected on mpMR
* mpMR suggesting presence of DILs in both lobes of the prostate
* Contraindications to receiving a MR-scan
* Medically unfit for general and/or spinal anesthesia
* IPSS score \> 15
* Inflammatory bowel disease
* Prior abdominal-perineal resection
* Presence of distant metastases and/or nodal disease
* Older than 75 years of age
* Use of cytoreductive prostate treatment (including 5 alpha-reductase inhibitors)
* NCCN-defined unfavourable intermediate or high-risk prostate cancer
* Signs of extra-capsular extension or seminal vesicle involvement on MR-scan
* Prior TURP
* \> 3mm of median lobe protrusion to bladder measured in mpMR (Roeloffzen 2011)
* Prior RT to the pelvis
* Significant artifact on MR-Scan (e.g. caused by hip prosthesis)