A Retrospective Review of Low- and Intermediate-Prostate Cancer Patients Treated with Brachytherapy at Chris Hani Baragwanath Academic Hospital

Abstract

Background: Prostate cancer is one of the leading causes of cancer-related mortality among South African men, with incidence rates expected to double over the next two decades. Aim: This study aimed to describe the sociodemographic, clinical, and treatment profiles of patients with low- and intermediate-risk prostate cancer treated with low- dose-rate (LDR) brachytherapy at a single institution. Setting: Chris Hani Baragwanath Academic Hospital, Soweto, Johannesburg, South Africa. Methods: We conducted a retrospective review of medical records for patients with low- to intermediate-risk prostate cancer who underwent LDR brachytherapy between 01 July 2021 and 31 December 2022, with follow-up data collected until 30 June 2023. Results: A total of 57 patients were included, with a median age of 66 years (range: 55–78). Most patients (63%) presented with low-risk disease, while 37% were classified as favourable intermediate-risk. Median initial PSA was 8.2 ng/mL. Gleason scores were predominantly 3+3, Grade Group 1 (52%) and 3+4, Grade Group 2 (40%). All patients received Iodine-125 LDR brachytherapy; 28% also received short-course androgen deprivation therapy. Median follow-up was 11 months. Grade 2 urinary toxicity was observed in 14% of patients; no grade ≥3 toxicities were reported. No biochemical recurrences were documented during the follow-up period. Conclusion: This study provides insight into the clinical and demographic characteristics of prostate cancer patients managed with LDR brachytherapy in a III South African public sector setting. It highlights the feasibility and relevance of brachytherapy as a treatment modality in resource-constrained environments. Contribution: These findings contribute to the growing body of literature on prostate cancer management in low- and middle-income countries (LMICs) and support the role of brachytherapy in expanding access to curative treatment, especially in a resource-constraint setting.