3D Interstitial HDR Brachytherapy Combined with 3D External Beam Radiotherapy and Androgen Deprivation for Prostate Cancer Preliminary Results

Martin, Thomas J.; Hey-Koch, Silla; Strassmann, Gerd; Kolotas, Christos; Baltas, Dimos; Rogge, Bernd; Röddiger, Sandra; Vogt, Hans-Georg; Heyd, Reinhard; Dannenberg, Thomas; Kurek, Ralf; Tunn, U.; Zamboglou, N.

doi:10.1007/pl00002344

Cited by 22 publications

(17 citation statements)

References 19 publications

(19 reference statements)

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“…Proctologic complications following conventional external radiation for prostate cancer have been reported to range from 6.6 to 14% (21). Most studies using a combination of HDR brachytherapy and external beam radiation found the incidence of grade 2 or greater proctitis to be less frequent (1.9-11.4%) (15)(16)(17)(18)(19)(20). Treatment plans exposing more than 40% of the anterior rectum to more than 75 Gy with conventional fractionation have been associated with an increase in the incidence of rectal bleeding (21).…”

Section: Discussionmentioning

confidence: 99%

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Toxicity and Health-related Quality of Life During and After High Dose Rate Brachytherapy Followed by External Beam Radiotherapy for Prostate Cancer

Egawa

Shimura²,

Irie³

et al. 2001

Japanese Journal of Clinical Oncology

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Background:The optimal protocol for combining high dose rate brachytherapy and external beam irradiation as treatment for localized prostate cancer is unknown. Toxicity rates and clinical and biochemical outcomes should be evaluated to validate the current treatment protocol. Methods: Fifty-eight patients were treated for prostate cancer with high dose rate brachytherapy followed by 30 Gy of external beam radiation therapy. Toxicity during treatment and for 12-18 months thereafter, and treatment-related morbidity, were evaluated. Physician-assessed treatment-related toxicity was graded at the time of occurrence using the Radiation Therapy Oncology Group morbidity criteria. Four separate self-administered questionnaires were used to collect longitudinally demographic data and general and prostate disease-related measures of quality of life. Results: Various degrees of rectal bleeding due to radiation proctitis were experienced by 13 patients (22%) at a median time of 11 months. Two of these patients needed hospitalization to undergo laser coagulation of the rectal mucosa. Study patients had statistically significant decreases in five SF-36 domains during the first month of treatment. All measures recovered by 12 months. Sexual function was not affected by irradiation. Lower urinary tract symptoms assessed by IPSS/QOL scores worsened significantly during the first month of treatment but later recovered to baseline levels. Physician-assessed RTOG scores failed to detect these changes. Conclusions: Morbidity associated with combined radiation therapy was greatest during the first month of treatment and affected quality of life significantly. Most measures recovered to baseline levels by 12 months following radiation therapy. Although the current protocol appears acceptable, measures should be taken to decrease treatment-related morbidity further. Key words: prostate cancer -high dose rate brachytherapy -external beam radiotherapy -quality of life

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Section: Discussionmentioning

confidence: 99%

“…There have been several investigations of combined treatment using different regimens (15)(16)(17)(18)(19)(20). The total biological effect of the combined treatment is usually difficult to determine.…”

Section: Discussionmentioning

confidence: 99%

Toxicity and Health-related Quality of Life During and After High Dose Rate Brachytherapy Followed by External Beam Radiotherapy for Prostate Cancer

Egawa

Shimura²,

Irie³

et al. 2001

Japanese Journal of Clinical Oncology

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“…Other HDR BT (/100 Gy) papers report 2 Á/11% grade 2Á/4 late GI toxicity [9,12,13,19], while papers reporting toxicity after conformal EBRT dose escalation (74 Á/79 Gy) [16,32 Á/34] indicate 6 Á/14% grade 2 Á/4 toxicity and papers concerning conventional/conformal EBRT (64Á/70 Gy) [17,30,35,37] report 5 Á/15%. The definition of the assessment point for late effects varies from 4 months to 24 months or more in these studies as well.…”

Section: Discussionmentioning

confidence: 99%

Combined curative radiotherapy including HDR brachytherapy and androgen deprivation in localized prostate cancer: A prospective assessment of acute and late treatment toxicity

et al. 2005

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Self-reported symptoms including urinary, bowel and sexual side effects were investigated prospectively at multiple assessment points before and after combined radiotherapy of prostate cancer including HDR brachytherapy and neoadjuvant androgen deprivation therapy. Between April 2000 and June 2003, patients with predominantly advanced localized prostate tumours subjected to this treatment were asked before treatment and on follow-up visits to complete a questionnaire covering urinary, bowel and sexual problems. The mainly descriptive analyses included 525 patients, responding to at least one questionnaire before or during the period 2 Á/34 months after radiotherapy. Adding androgen deprivation before radiotherapy significantly worsened sexual function. During radiotherapy, urinary, bowel and sexual problems increased and were reported at higher levels up to 34 months, although there seemed to be a general tendency to less pronounced irritative bowel and urinary tract symptoms over time. No side effects requiring surgery were reported. Classic late irradiation effects such as mucosal bleeding were demonstrated mainly during the second year after therapy, but appear less pronounced in comparison with dose escalated EBRT series. In conclusion, despite the high radiation dose given, the toxicity seemed comparable with that of other series but long term (5 Á/10 years) symptom outcome has to be determined.

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“…In radiation therapy major improvements have been made by the introduction of 3-D conformal therapy techniques especially for prostate cancer [9,12,20]. Many critical parameters have been examined e.g.…”

Section: Discussionmentioning

confidence: 99%

Computed Tomogram prior to Prostatectomy

Höcht

Wiegel²,

Bottke³

et al. 2002

Strahlentherapie und Onkologie

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3D Interstitial HDR Brachytherapy Combined with 3D External Beam Radiotherapy and Androgen Deprivation for Prostate Cancer Preliminary Results

Abstract: The new 3D HDR brachytherapy technique, combined with 3D external irradiation and androgen deprivation, is a feasible, so far well-tolerated and effective treatment in the short-time follow-up of median 18 months.

Cited by 22 publications

References 19 publications

Toxicity and Health-related Quality of Life During and After High Dose Rate Brachytherapy Followed by External Beam Radiotherapy for Prostate Cancer

Toxicity and Health-related Quality of Life During and After High Dose Rate Brachytherapy Followed by External Beam Radiotherapy for Prostate Cancer

Combined curative radiotherapy including HDR brachytherapy and androgen deprivation in localized prostate cancer: A prospective assessment of acute and late treatment toxicity

Computed Tomogram prior to Prostatectomy

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