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Favorable Preliminary Outcomes for Men With Low- and Intermediate-risk Prostate Cancer Treated With 19-Gy Single-fraction High-dose-rate Brachytherapy.
- Source :
-
International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 2017 Jan 01; Vol. 97 (1), pp. 98-106. Date of Electronic Publication: 2016 Nov 09. - Publication Year :
- 2017
-
Abstract
- Purpose: To report the toxicity and preliminary clinical outcomes of a prospective trial evaluating 19-Gy, single-fraction high-dose-rate (HDR) brachytherapy for men with low- and intermediate-risk prostate cancer.<br />Methods and Materials: A total of 63 patients were treated according to an institutional review board-approved prospective study of single-fraction HDR brachytherapy. Eligible patients had tumor stage ≤T2a, prostate-specific antigen level ≤15 ng/mL, and Gleason score ≤7. Patients with a prostate gland volume >50 cm <superscript>3</superscript> and baseline American Urologic Association symptom score >12 were ineligible. Patients underwent transrectal ultrasound-guided transperineal implantation of the prostate, followed by single-fraction HDR brachytherapy. Treatment was delivered using <superscript>192</superscript> Ir to a dose of 19 Gy prescribed to the prostate, with no additional margin applied.<br />Results: Of the 63 patients, 58 had data available for analysis. Five patients had withdrawn consent during the follow-up period. The median follow-up period was 2.9 years (range 0.3-5.2). The median age was 61.4 years. The median gland volume at treatment was 34.8 cm <superscript>3</superscript> . Of the 58 patients, 91% had T1 disease, 71% had Gleason score ≤6 (29% with Gleason score 7), and the median pretreatment prostate-specific antigen level was 5.1 ng/mL. The acute and chronic grade 2 genitourinary toxicity incidence was 12.1% and 10.3%, respectively. No grade 3 urinary toxicity occurred. No patients experienced acute rectal toxicity grade ≥2, and 2 experienced grade ≥2 chronic gastrointestinal toxicity. Three patients experienced biochemical failure, yielding a 3-year cumulative incidence estimate of 6.8%.<br />Conclusions: Single-fraction HDR brachytherapy is well-tolerated, with favorable preliminary biochemical and clinical disease control rates.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Adenocarcinoma blood
Adenocarcinoma pathology
Adult
Aged
Brachytherapy adverse effects
Follow-Up Studies
Humans
Iridium Radioisotopes therapeutic use
Male
Middle Aged
Neoplasm Grading
Non-Randomized Controlled Trials as Topic
Organ Size
Prostate pathology
Prostate-Specific Antigen blood
Prostatic Neoplasms blood
Prostatic Neoplasms pathology
Radiotherapy Dosage
Risk
Time Factors
Treatment Outcome
Ultrasonography, Interventional
Urination Disorders etiology
Adenocarcinoma radiotherapy
Brachytherapy methods
Prostatic Neoplasms radiotherapy
Subjects
Details
- Language :
- English
- ISSN :
- 1879-355X
- Volume :
- 97
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- International journal of radiation oncology, biology, physics
- Publication Type :
- Academic Journal
- Accession number :
- 27979460
- Full Text :
- https://doi.org/10.1016/j.ijrobp.2016.08.011