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Objective: To investigate the efficacy of brachytherapy for patients with localized prostate cancer and the influence factors.Methods: A total of 61 patients with localized prostate cancer were treated with brachytherapy between 2001 and 2011,including 11 patients who received combined external beam radiotherapy.The mean age was 75.2 yr(range,57-84 yr).Clinical stage was Tlc in 12 patients,T2a in 18 patients,T2b in 17 patients,and T2c in 14 patients.Longterm follow-up was carried on all patients for PSA and adverse effects.Kaplan-Meier survival curves,Log-rank test and univariate Cox proportional hazard regression analysis was used to examine the factors associated with the treatment efficacy.Results: The median follow-up was 49 months(range,9-126 months).The mean PSA before treatment and the mean nadir PSA after operation were 17.80 and 1.16 μg/L,respectively.The PSA of 58 patients(95.1%)reached a nadir below 4 μg/L,which was even below 1 μg/L in 37 patients(60.7%).The mean time to reach the nadir PSA was 11.6 months after operation.The short-term adverse events after operation included fever in 4 patients,hematuria in 7 patients,and hematochezia in 4 patients.The most common long-term adverse event was urinary irritation(31%);other long-term adverse events were rare,including hematochezia,hematuria,urinary incontinence,urinary retention,mild diarrhea and radiation enteritis.The estimated mean biochemical recurrence-free survival after brachytherapy was 41.0 months(95%CI: 31.05-50.94 months).The mean nadir PSA after operation were 1.32 μg/L in the 11 patients who received combined external beam radiotherapy,and their estimated mean biochemical recurrence-free survival was 38 months.Patients with nadir PSA below 1 μg/L had a significant longer biochemical recurrence-free survival than those with nadir PSA between 1 and 4 μg/L(42.9 vs.32.0 months,x2=4.445,P=0.035).Conclusions: Brachytherapy is an effective treatment strategy for localized prostate cancer,with relatively low rate of severe adverse events.After brachytherapy,a nadir PSA below 1 μg/L might indicate a better prognosis.