Urabe F, Miki K, Kimura T, et al. - For patients with intermediate-risk (IR) prostate cancer scheduled for low-dose-rate brachytherapy (LDR-BT), multimodal irradiation is recommended in the presence of two or more unfavorable factors at diagnosis. This observation is based on long-term treatment outcomes.

• This study involved 693 patients with localized IR prostate cancer managed via LDR-BT with or without external beam radiation and with or without androgen-deprivation therapy in a single institution.

• Of participants, favorable disease was evident in 292 (42.1%); the remaining 401 (57.9%) exhibited unfavorable disease.

• Shorter biochemical recurrence-free survival and clinical progression-free survival were observed in relation to unfavorable IR status, vs favorable IR status.

• The worst oncological outcomes were seen in those with two to three unfavorable factors.

• Similar response to LDR-BT monotherapy was obtained in cases with one or no unfavorable factors but this treatment modality proved insufficient for averting biochemical and clinical progression in those with multiple unfavorable findings.