Focal brachytherapy for localized prostate cancer: Urinary toxicity depends on tumor location

Srougi, Victor; Barret, Éric; Nunes‐Silva, Igor; Baghdadi, Mohammed; García‐Barreras, Silvia; Pierrat, N.; Rozet, François; Galiano, Marc; Sánchez-Salas, Rafael; Cathelineau, Xavier; Cosset, Jean‐Marc

doi:10.1016/j.brachy.2017.05.009

Cited by 24 publications

(15 citation statements)

References 32 publications

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“…Further ultra-focal LDR-PB studies with 125 I seeds [22,23] showed very similar urinary and erectile function treatment-related effects to those of our present study. Interestingly, Srougi et al [22,23] reported urinary toxicity was dependent on tumour location. Apical implants showed increased IPSSs that persisted at 24 months after treatment, whereas basal focal implants did not.…”

Section: Disease Control Beyond 24 Monthssupporting

confidence: 86%

“…A recent pilot study on ultra‐focal LDR‐PB found that uncertainty in identifying untreated tissue areas on the post‐implant CT images impeded the ability to accurately repeat template biopsies . Further ultra‐focal LDR‐PB studies with 125 I seeds showed very similar urinary and erectile function treatment‐related effects to those of our present study. Interestingly, Srougi et al .…”

Section: Discussionsupporting

confidence: 57%

“…Interestingly, Srougi et al . reported urinary toxicity was dependent on tumour location. Apical implants showed increased IPSSs that persisted at 24 months after treatment, whereas basal focal implants did not.…”

Section: Discussionmentioning

confidence: 98%

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Hemi‐ablative low‐dose‐rate prostate brachytherapy for unilateral localised prostate cancer

Langley¹,

Uribe²,

Uribe-Lewis³

et al. 2019

BJU International

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Objectives To report clinical outcomes of the Hemi‐Ablative Prostate Brachytherapy (HAPpy) trial evaluating treatment‐related toxicity and effectiveness of hemi‐gland (HG) low‐dose‐rate (LDR) prostate brachytherapy as a focal approach to control unilateral localised prostate cancer. Patients and Methods Single institution phase IIS pilot study of patients treated with focal 4D Brachytherapy™ (BXTAccelyon, Burnham, Buckinghamshire, UK). The primary outcome was patient‐reported toxicity 24 months after implant. The secondary outcome was assessment of disease control. Outcomes in HG patients were compared to whole‐gland (WG) controls obtained from our prospective cohort registry by negative binomial and linear regression models. Results Pre‐treatment demography was similar between the 30 HG patients and 362 WG controls. Post‐implant dosimetry was similar for the prostate gland target volumes and significantly reduced for the urethra and bowel in HG patients relative to WG controls, but this did not translate into a difference in post‐implant mean symptom scores between the two groups. Nevertheless, the change in score from baseline indicated that the impact on pre‐treatment symptom status was less after HG implants. Only HG patients showed a return to baseline urinary scores as early as 12 months. Sexual potency was conserved in 73% and 67% of HG and WG patients, respectively (P = 0.84). Post‐implant prostate‐specific antigen (PSA) kinetics revealed that baseline PSA was reduced at 24 months by 78% and 88% in HG and WG patients, respectively (P < 0.05). Treatment relapse occurred in one (3%) HG patient 55 months after implant and in nine (3%) WG patients at 32–67 months after implant. Conclusion This pilot study suggests that treatment‐related toxicity and biochemical outcomes after HG implants are broadly similar to those observed with WG treatment despite the lower dose delivered by HG implants.

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Section: Disease Control Beyond 24 Monthssupporting

confidence: 86%

Section: Discussionsupporting

confidence: 57%

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Hemi‐ablative low‐dose‐rate prostate brachytherapy for unilateral localised prostate cancer

Langley¹,

Uribe²,

Uribe-Lewis³

et al. 2019

BJU International

View full text Add to dashboard Cite

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“…In a systematic review, Peach et al (39) described data from 6 clinical studies and 9 dosimetry studies on focal high-and low-dose rate brachytherapy. Followup in all studies was less than 60 months and the recurrence rate was found to be up to 29% in one series , but this was found to be dependent on the location of the treated lesion (40). Targeting the peripheral zone only by iodine-125 sources, was found to be associated with high recurrence rates in intermediaterisk patients (41).…”

Section: Focal Brachytherapymentioning

confidence: 92%

Focal Therapy in Primary Localised Prostate Cancer : The European Association of Urology Position in 2018

Poel

Bergh

Briers³

et al. 2018

European Urology

144

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Focal therapy of prostate cancer is the targeted destruction of cancer within a specific part of the prostate gland, sparing the rest of the prostate and nearby tissue. This procedure could potentially reduce side effects when compared with established standard treatments, such as surgery or radiotherapy, which treat the entire prostate. Studies show that for most men with low-risk cancer, active surveillance is the preferred treatment option. However, the available data regarding all forms of focal therapy are still poor and inconclusive. Consequently, due to both the lack of clear results associated with focal therapy and the difficulties in detecting all cancerous areas of the prostate, focal therapy should be considered an investigational modality only.

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“…The most common of them are focal cryotherapy, HIFU and brachytherapy. Focal cryotherapy (Shah et al, 2014) (Peach, Trifiletti, & Libby, 2016;Srougi et al, 2017). The medium-term oncological outcomes of brachytherapy were comparable to cryotherapy.…”

Section: Discussionmentioning

confidence: 98%

A systematic review of irreversible electroporation in localised prostate cancer treatment

et al. 2020

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Irreversible electroporation is a treatment option used for focal therapy. In this systematic review, we summarise data on irreversible electroporation outcomes in patients with localised prostate cancer. We performed a literature search in 3 databases and included articles with own data on irreversible electroporation results in patients with localised prostate cancer. Primary outcome was procedure efficacy measured as the absence of cancer in the treatment area on the follow-up biopsy. Secondary outcomes were the absence of prostate cancer recurrence in the treatment area on MRI, out-of-field recurrence, complications and functional outcomes (erectile function and micturition). In-field recurrence rate was 0%-39% and out-field 6.4%-24%. In all studies, PSA level decreased: twice lower than baseline after 4 weeks and by 76% after 2 years. Most of the authors noted sexual and urinary toxicity during the first half year after surgery. However, functional outcomes recovered to baseline after 6 months with mild decrease in sexual function. Complication rates after irreversible electroporation were 0%-1% of Clavien-Dindo III and 5%-20% of Clavien-Dindo I-II. Irreversible electroporation has promise oncological outcomes, rate of post-operative complications and minimal-to-no effects on erectile and urinary function. However, medium and long-term data on cancer-specific and recurrence-free survival are still lacking.

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Focal brachytherapy for localized prostate cancer: Urinary toxicity depends on tumor location

Cited by 24 publications

References 32 publications

Hemi‐ablative low‐dose‐rate prostate brachytherapy for unilateral localised prostate cancer

Hemi‐ablative low‐dose‐rate prostate brachytherapy for unilateral localised prostate cancer

Focal Therapy in Primary Localised Prostate Cancer : The European Association of Urology Position in 2018

A systematic review of irreversible electroporation in localised prostate cancer treatment

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