Abstract
Background
To evaluate acute and late genitourinary, the gastrointestinal toxicity and the long-term
biochemical control after HDR monotherapy in one fraction (19 Gy).
Patients and methods
Between April 2008 and October 2010, 60 consecutive patients were treated with favorable
clinically localized prostate cancer; the median follow-up was 72 months (range 32–91). All patients received one implant and one fraction of HDR. Fraction
dose was 19 Gy.
Toxicity was reported according to the Common Toxicity Criteria for Adverse Event,
Version 4.0 (CTAE v4.02) by the National Cancer Institute.
Results
No intraoperative or perioperative complications occurred. Acute toxicity grade 2
or more was not observed in any patients. No chronic toxicity, such as incontinence,
late urinary retention, urethral narrowing, rectal bleeding, anal ulcer and/or rectourethral
fistula has been observed after treatment.
The overall survival and failure in tumor-free survival (TFS) according to Kaplan–Meier
estimates was 90% (±5%) and 88% (±5%) respectively at 6 years. The actuarial biochemical control was 66% (±6%) at 6 years.
Conclusions
This protocol is feasible and very well tolerated with low genitourinary morbidity,
no gastrointestinal toxicity but no the same level of LDR biochemical control at 6 years.
Abbreviations:
AJCC (American Joint Committee on Cancer), BED (Biologically effective dose), CTAE v4.02 (Common Toxicity Criteria for Adverse Event, version 4.02), CTV (Clinical target volume), D90 (The dose that covers 90% volume of CTV), D100 urethra (Dose delivered to 100% of the urethra), DVH (Dose–volume histogram), GI (Gastrointestinal), GU (Genitourinary), HDR (High dose rate), IMRT (Intensity modulated radiotherapy), LDR (Low dose rate), PSA (Serum prostate-specific antigen), PTV (Planning target volume), PD (Prescribed dose), SPSS (Statistical analysis SPSS), SD (Standard deviations), TFS (Tumor-free survival), TRUS (The trans-rectal ultrasound), V90-100-150-200 (% of PTV receiving 90%, 100%, 150%, 200% of the PD)), V120 urethra (Volume that received a dose of 120% of the urethra)Keywords
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References
- The National cancer data base report on increase use of brachytherapy for the treatment of patients with prostate carcinoma in the USA.Cancer. 1999; 86: 1877-1882
- The 1999 Patterns of care Study of radiotherapy in localized prostatic carcinoma. A comprehensive survey of prostate brachytherapy in the United States.Cancer. 2003; 98: 1987-1994
- ESTRO/EAU/EORTC recommendations on permanent seed implantation for localized prostate cancer.Radiother Oncol. 2000; 57: 315-321
- Results of permanent prostate brachytherapy, 13 years of experience at a single institution.Radiother Oncol. 2004; 71: 23-28
- AJCC Cancer staging Manual.5th edn. Pennsylvania; Lippincitt-Raven, Philadelphia1997
- Dose escalation with three-dimensional conformal radiation therapy affects the outcome in prostate cancer.Int J Radiat Oncol Biol Phys. 1998; 41: 491-500
- Transperineal injection of hyaluronic acid in the anterior peri-rectal fat to decease rectal toxicity from radiation delivered with intensity modulated brachytherapy or EBRT for prostate cancer patients.Int J Oncol Biol Phys. 2007; 69: 95-102
- Transperineal injection of hyaluronic acid in the anterior peri-rectal fat to decrease rectal toxicity from radiation delivered with low dose rate brachytherapy for prostate cancer patients.Brachytherapy. 2009; 8: 210-217
- Defining biochemical failure following radiotherapy with or without hormonal Therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference.Int J Radiat Oncol Biol Phys. 2006; 65: 965-974
- High-dose-rate brachytherapy as monotherapy delivered in two fractions within one day for favorable/intermediate-risk prostate cancer: preliminary toxicity data.Int J Radiat Oncol Biol Phys. 2012; 83: 927-932
- Toxicity and early treatment outcomes in low and intermediate-risk prostate cancer managed by high-dose-rate brachytherapy as a monotherapy.Brachytherapy. 2009; 8: 45-51
- 3-D conformal HDR brachytherapy as monotherapy for localized prostate cancer. A pilot study.Strahlenther Onkol. 2004; 180: 225-232
- Monotherapeutic high-dose-rate brachytherapy for prostate cancer: five-year results of an extreme hypofractionation regimen with 54 Gy in nine fractions.Int J Radiat Oncol Biol Phys. 2011; 80: 469-475
- Correlation between dosimetric parameters and late rectal and urinary toxicities in patients treated with high-dose-rate brachytherapy used as monotherapy for prostate cancer.Int J Oncol Biol Phys. 2009; 75: 1003-1007
- High-dose-rate brachytherapy alone given as two or one fraction to patients for locally advanced prostate cancer: acute toxicity.Radiother Oncol. 2014; 110: 268-271
- High-dose-rate prostate brachytherapy consistently results in high quality dosimetry.Int J Radiat Oncol Biol Phys. 2013; 85: 543-548
- High-dose-rate interstitial brachytherapy as monotherapy for clinically localized prostate cancer: treatment evolution and mature results.Int J Radiat Oncol Biol Phys. 2012; 85: 672-678
Article info
Publication history
Published online: April 22, 2016
Accepted:
April 4,
2016
Received in revised form:
March 7,
2016
Received:
December 28,
2015
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.