Background. Among malignant tumors in men in Russia, prostate cancer is the most common comprising 17 %. Despite the high effectiveness of radiotherapy for prostate cancer in about 20 % of patients, radiation damage of the pelvic organs develops affecting bladder, rectum, and intrapelvic cellular tissue.Aim. To evaluate early and late complications of high dose-rate brachytherapy.Materials and methods. Literature review was performed, and our own results of treatment of 276 patients using high dose-rate brachytherapy as monotherapy with different fractionation regimens: 19 Gy per 1 fraction and 15 Gy per 2 fractions were analyzed.Results. High dose-rate brachytherapy as monotherapy is associated with low complication rate. There were no statistically significant differences between singleand two-fraction regimens. Evaluation of complication severity per the RTOG (Radiation Therapy Oncology Group) classification did not show complication severity above grade III. Early complications were diagnosed in 1.1 %, late in 3.3 % of cases. Between the treatment and comparison groups, no statistically significant differences in the frequency of urinary system organ symptoms per the IPSS (International Prostate Symptom Score) questionnaire were registered. Mean score per the IPSS prior to treatment was 4.0 (3.0–6.0) in the treatment group and 4.0 (3.0–8.5) in the comparison group. Mean follow-up duration in the treatment group was 65.0 (60.0–70.0) months, in the comparison group – 55.0 (49.5–65.0) months. After the treatment, mean IPSS score was 5.0 (4.0–5.0) in the treatment group and 5.0 (3.0–7.0) in the comparison group.Conclusion. High dose-rate brachytherapy as monotherapy and in combination with external beam therapy is a safe and effective treatment method in prostate cancer. Serious and late complications are rare, however toxic effects of severity grades I or II can develop. Careful patient selection for brachytherapy, therapy planning methods, as well as active management of early and late toxicity by a multidisciplinary team with knowledge and experience in treatment of side effects of radiotherapy can help optimize treatment with high dose-rate brachytherapy.
