Comparative study of late rectal toxicity in prostate cancer patients treated with low-dose-rate brachytherapy: With or without supplemental external beam radiotherapy

Serrano, N.; Moghanaki, Drew; Asher, David; Karlin, Jeremy; Schutzer, M.E.; Chang, Michael; Hagan, Michael P.

doi:10.1016/j.brachy.2016.04.002

Cited by 19 publications

(11 citation statements)

References 33 publications

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“…There have been several reports to compare the treatment outcomes and GU or GI toxicities [ 8 , 9 , 10 , 11 , 12 , 13 , 14 ]. However, they included a variety of LDR-BT modalities or sources, or different prescribed doses such as mixed 125 I and 103 Pb [ 8 , 15 , 16 ]. In one study, the LDR-BT procedure included both pre-operative planning and intraoperative planning [ 12 ], and in another only pre-operative planning was used [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, they included a variety of LDR-BT modalities or sources, or different prescribed doses such as mixed 125 I and 103 Pb [ 8 , 15 , 16 ]. In one study, the LDR-BT procedure included both pre-operative planning and intraoperative planning [ 12 ], and in another only pre-operative planning was used [ 8 ]. The prescribed dose of LDR-BT was not uniform, ranging from 137-160 Gy [ 8 , 12 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

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Acute and late toxicities in localized prostate cancer patients treated with low-dose 125I brachytherapy (110 Gy) in combination with external beam radiation therapy versus brachytherapy alone (160 Gy)

Mukai

Hayashi

Koike

et al. 2018

jcb

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PurposeThe aim of this analysis was to compare acute and late toxicities between low-dose-rate brachytherapy (LDR-BT) (110 Gy) in combination with 45 Gy in 25 fractions external beam radiation therapy (EBRT) and LDR-BT (160 Gy) alone for localized prostate cancer.Material and methodsOne hundred five consecutive patients with localized prostate cancer treated from May 2014 to May 2017 were included in this retrospective analysis. Sixty patients received combination therapy and 45 patients received BT monotherapy. The LDR-BT procedure was performed using 125I seeds.ResultsThe median follow-up time was 28 months in both groups. Three-year effect rates were overall survival: 100% in both groups. The biochemical failure rate was 2.3% in the combination group and 0% in the monotherapy group (p = 0.373). No patients died during the study period. In both groups, almost all the patients experienced acute urethritis. There was a significant difference between the combination therapy group (8.3%) and BT monotherapy group (11.1%) in late genitourinary (GU) toxicities ≥ grade 2 (p = 0.035). Only 2 patients (3.3%) in the combination therapy group developed late ≥ grade 2 rectal hemorrhage. There were no significant differences between two groups in hematuria ≥ grade 2 (p = 0.068) or rectal hemorrhage ≥ grade 2 (p = 0.206).ConclusionsTo our knowledge, this is the first report to compare the GU and gastrointestinal toxicities between the combination therapy and BT monotherapy (160 Gy) for localized prostate cancer. Unexpectedly, there were more late GU toxicities (except for hematuria) in the BT monotherapy group.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Acute and late toxicities in localized prostate cancer patients treated with low-dose 125I brachytherapy (110 Gy) in combination with external beam radiation therapy versus brachytherapy alone (160 Gy)

Mukai

Hayashi

Koike

et al. 2018

jcb

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“…There are four options available for the management of localized prostate cancer, including radical prostatectomy, brachytherapy, external beam radiotherapy, and active surveillance. All management options are considered to be equally efficacious, for most men, for prevention of mortality, however, each option has its own set of unique consequences ( Hamdy et al, 2016 ; Resnick et al, 2013 ; Zelefsky et al, 2016 ; Serrano et al, 2016 ). Other therapies such as cryotherapy and androgen deprivation therapy are not used for localized disease within Saskatchewan ( Saskatchewan Cancer Agency, 2003 ).…”

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confidence: 99%

Understanding Medical Decision-making in Prostate Cancer Care

et al. 2018

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The availability of several treatment options for prostate cancer creates a situation where patients may need to come to a shared decision with their health-care team regarding their care. Shared decision-making (SDM) is the concept of a patient and a health-care professional collaborating to make decisions about the patient’s treatment course. Nurse navigators (NNs) are health-care professionals often involved in the SDM process. The current project sought to evaluate the way in which patients with prostate cancer make decisions regarding their care and to determine patients’ perspectives of the role of the NN in the SDM process. Eleven participants were recruited from the Prostate Assessment Centre by a NN. They were interviewed via telephone and their responses were analyzed using thematic analysis. Five interacting factors were determined to influence the way participants made decisions including level of anxiety, desire to maintain normalcy, support system quality, exposure to cancer narratives, and extent of practical concerns. NNs were found to increase knowledge, decrease indecision, and provide reassurance for participants. Based on the beneficial aspects of NN interaction reported in this study, the use of NNs in SDM programs should be encouraged. The results of the study demonstrate the complexity of the decision-making process when it comes to prostate cancer treatment. The factors elucidated in the study should be considered during the development and implementation of prostate cancer SDM programs.

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“…For men with localized prostate cancer, LDR/HDR monotherapy or EBRT combined with LDR/HDR boost provides excellent biochemical outcomes [ 1 ], and several studies have reported superior outcomes, reduced toxicities, and excellent quality of life at a low-cost from either form of brachytherapy when compared to other treatments. Prostate brachytherapy offers suitable men an outstanding opportunity to achieve a high-dose, precisely targeted, and convenient treatment with excellent biochemical outcomes [ 2 , 3 , 7 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

UK & Ireland Prostate Brachytherapy Practice Survey 2014-2016

Corey¹,

Yoosuf²,

Workman³

et al. 2018

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PurposeTo document the current prostate brachytherapy practice across the UK and Ireland and compare with previously published audit results.Material and methodsParticipants from 25 centers attending the annual UK & Ireland Prostate Brachytherapy Conference were invited to complete an online survey. Sixty-three questions assessed the center’s experience and staffing, clinician’s experience, clinical selection criteria and scheduling, number of cases per modality in the preceding three years, low-dose-rate (LDR) pre- and post-implant technique and high-dose-rate (HDR) implant technique. Responses were collated, and descriptive statistical analysis performed.ResultsEighteen (72%) centers responded with 17 performing LDR only, 1 performing HDR only, and 6 performing both LDR and HDR. Seventy-one percent of centers have > 10 years of LDR brachytherapy experience, whereas 71% centers that perform HDR brachytherapy have > 5 years of experience. Thirteen centers have 2 or more clinicians performing brachytherapy with 61% of lead consultants performing > 25 cases (LDR + HDR) in 2016. The number of implants (range), that includes LDR and HDR, performed by individual practitioners in 2016 was > 50 by 21%, 25-50 by 38%, and < 25 by 41%. Eight centers reported a decline in LDR monotherapy case numbers in 2016. Number of center’s performing HDR brachytherapy increased in last five years. Relative uniformity in patient selection is noted, and LDR pre- and post-implant dosimetry adheres to published quality guidelines, with an average post-implant D90 of > 145 Gy in 69% of centers in 2014 and 2015 compared to 63% in 2016. The median CT/US volume ratios were > 0.9 ≤ 1.0 (n = 4), > 1.0 ≤ 1.1 (n = 7), and > 1.1 (n = 2).ConclusionThere is considerable prostate brachytherapy experience in the UK and Ireland. An apparent fall in LDR case numbers is noted. Maintenance of case numbers and ongoing compliance with published quality guidelines is important to sustain high quality outcomes.

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Comparative study of late rectal toxicity in prostate cancer patients treated with low-dose-rate brachytherapy: With or without supplemental external beam radiotherapy

Cited by 19 publications

References 33 publications

Acute and late toxicities in localized prostate cancer patients treated with low-dose 125I brachytherapy (110 Gy) in combination with external beam radiation therapy versus brachytherapy alone (160 Gy)

Acute and late toxicities in localized prostate cancer patients treated with low-dose 125I brachytherapy (110 Gy) in combination with external beam radiation therapy versus brachytherapy alone (160 Gy)

Understanding Medical Decision-making in Prostate Cancer Care

UK & Ireland Prostate Brachytherapy Practice Survey 2014-2016

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