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What prostate size or baseline urinary symptoms are relative contraindications for prostate HDR?

It seems that some high volume centers have expanded their selection of patients for both HDR monotherapy and boosts. If you do have size or IPSS cutoffs, what are they? And is your IPSS cutoff with or without alpha blocker therapy? What sis the largest prostate size that you would treat?
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Radiation Oncology · GammaWest Cancer Services
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Prostate volume has been a limiting factor with permanent seed brachytherapy in some patients with a large prostate and a narrow pelvic inlet. A prostate volume >60cc is used by some as a relative threshold, but is not tightly adhered to by many experienced brachytherapists. With permanent LDR prost...

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