Table 4. Summary of studies showing toxicity after high dose rate (HDR) brachytherapy combined with external beam radiotherapy.

Reference	Sample size	Genitourinary toxicity	Gastrointestinal toxicity	Erectile dysfunction	Follow-up (months)
Borghede et al [50]	n=50	8% G3	0% G3	10%	45
Mate et al [58]	n=104	6.7% urethral stricture
Kestin et al [31]	n=161	5% G3, 0% G4		29%	36
		4% urethral stricture
Syed et al [61]	n=200	20% G3, 10% G4, late 2% G3	1.5%	30%	30
		1.5% urethral stricture
		<1% urinary incontinence
Deger et al [35]	n=230	12.2% G3 and 4	1.7% recto-urethral fistula		40
		7.4% urethral strictures
		3% G2–3 urinary incontinence
Galalae et al [52]	n=144	2.3% G3	4.1% G3		96
Martinez et al [44]	n=207	8% G3, 0% G4	0.5% G3, 0.5% G4	51%	60
		1.4% urethral stricture
Martin et al [56]	n=2004	5% G3	1% G3		32
Hiratsuka et al [53]	n=71	6% urethral structure			44
Aström et al [34]	n=214	17% transient haematuria	0% G3	14%	48
		7% urethral stricture
Demanes et al [37]	n=209	6.7% G3, 1% G4	0%	33%	120
		6.7% urethral stricture
		3.8% urinary incontinence
Izard et al [43]	n=165	3% G3, 1.4% G4	2.6% G3, 0% G4	39%	60
		1.2% urinary incontinence
Yamada et al [47]	n=105			47%	60
Chin et al [51]	n=65	4.6% G3	0%		42
		6.2% G3, 1.5% G4
		4.6% urethral stricture
Flynn et al [38]	n=674	2.5% and 15.8% urinary incontinence without and with previous TURP	0%	35% at 1 year, 40% at 2 years	60
Guix et al [41]	n=445	17.2% G2	21.6% G2		60
Phan et al [46]	n=309	4% G3	1% G3	38%	60
		1% urinary incontinence
		4.5% urethral stricture
Rades et al [59]	n=41	No G3 early or late toxicity		24–35%
Kalkner et al [55]	n=154	4% G3	1% G3		72
Sato et al [60]	n=53	0% G2	3.8% G2	22.6%	60
Zwahlen et al [62]	n=196	7.1% G3	0% G3		66
		No G4 toxicity
Hsu et al [54]	n=112	2.6% G3	3.6% G3	27.7%	30
		0.9% urethral stricture
		0.9% urinary incontinence
Martinez et al [57]	n=472	2–3% G3	<0.5% G3		120
Agoston et al [36]	n=280	14.4% G3	2.1% G3		60
		29.1% G3 previous TURP

G, grade; TURP, transurethral resection of prostate.