Focal salvage iodine-125 brachytherapy for prostate cancer recurrences after primary radiotherapy: A retrospective study regarding toxicity, biochemical outcome and quality of life

Peters, Max; Zyp, Jochem R.N. van der Voort van; Moerland, Marinus A.; Moman, Maaike R.; Steuten, Lotte Maria Gertruda; Deursen, Marijke J.H. van; Vulpen, Marco van

doi:10.1016/j.radonc.2014.06.013

Cited by 85 publications

(81 citation statements)

References 32 publications

(50 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The group from Utrecht recently published their preliminary experience with mp-MRIebased focal sPPI with iodine seeds after primary EBRT. Among 20 patients treated, six had subsequent biochemical failure after a median followup of 3 years, thus underlining the high risk of local failure with long-term followup after focal sPPI (26). Of note, three of these patients had no initial response to focal salvage brachytherapy.…”

Section: Discussionmentioning

confidence: 99%

Focal or whole-gland salvage prostate brachytherapy with iodine seeds with or without a rectal spacer for postradiotherapy local failure: How best to spare the rectum?

et al. 2016

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Focal or whole-gland salvage prostate brachytherapy with iodine seeds with or without a rectal spacer for postradiotherapy local failure: How best to spare the rectum?

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Other series have provided risk factors for biochemical failure with small groups of whole-gland salvage LDR I-125/Pd-103 and HDR Ir-192-brachytherapy patients and even focal salvage approaches (directed locally at the recurrence) [10][11][12][13][24][25][26][27][28][29][30] . Only a few of the whole-gland salvage brachytherapy studies provide multivariable modelling, with often limited events, categorisation of predictor variables and insufficient description of handling missing data, leading to imprecise estimates [11][12][13]26 .…”

Section: Discussionmentioning

confidence: 99%

Multivariable model development and internal validation for prostate cancer specific survival and overall survival after whole-gland salvage Iodine-125 prostate brachytherapy

Peters

Zyp

Moerland

et al. 2016

Radiotherapy and Oncology

Self Cite

View full text Add to dashboard Cite

Background: Whole-gland salvage Iodine-125-brachytherapy is a potentially curative treatment strategy for localised prostate cancer (PCa) recurrences after radiotherapy. Prognostic factors influencing PCa-specific and overall survival (PCaSS & OS) are not known. The objective of this study was to develop a multivariable, internally validated prognostic model for survival after whole-gland salvage I-125-brachytherapy.

show abstract

“…The transition possibility from DFS to BCR and probabilities for toxicities were derived from two cohorts from the University Medical Center Utrecht (UMCU) [10, 19]. Twenty patients were treated with FS and 31 patients with TS brachytherapy.…”

Section: Methodsmentioning

confidence: 99%

“…The first FS series show promising results with usually ≤ 5% grade 3 toxicity and cancer control rates comparable to total salvage (TS) [15, 16, 17, 18, 19, 20]. In the University Medical Center Utrecht (UMCU), two cohort studies of FS [19] and TS [10] 125 I brachytherapy have been performed. These studies have shown differences in severe GI and GU toxicity rates in favor of FS, while cancer control is maintained, possibly leading to a difference in cost-effectiveness between the two modalities.…”

Section: Purposementioning

confidence: 99%

Comparative cost-effectiveness of focal and total salvage 125 I brachytherapy for recurrent prostate cancer after primary radiotherapy

Peters¹,

Piena²,

Steuten³

et al. 2016

jcb

Self Cite

View full text Add to dashboard Cite

PurposeFocal salvage (FS) iodine 125 (125I) brachytherapy could be an effective treatment for locally radiorecurrent prostate cancer (PCa). Toxicity is often reduced compared to total salvage (TS) while cancer control can be maintained, which could increase cost-effectiveness. The current study estimates the incremental cost per quality-adjusted life year (QALY) of FS compared to TS.Material and methodsA decision analytic Markov model was developed, which compares costs and QALYs associated with FS and TS. A 3-year time horizon was adopted with six month cycles, with a hospital perspective on costs. Probabilities for genitourinary (GU) and gastrointestinal (GI) toxicity and their impact on health-related quality of life (SF-36) were derived from clinical studies in the University Medical Center Utrecht (UMCU). Probabilistic sensitivity analysis, using 10,000 Monte Carlo simulations, was performed to quantify the joint decision uncertainty up to the recommended maximum willingness-to-pay threshold of €80,000/QALY.ResultsFocal salvage dominates TS as it results in less severe toxicity and lower treatment costs. Decision uncertainty is small, with a 97-100% probability for FS to be cost-effective compared to TS (€0-€80,000/QALY). Half of the difference in costs between FS and TS was explained by higher treatment costs of TS, the other half by higher incidence of severe toxicity. One-way sensitivity analyses show that model outcomes are most sensitive to utilities and probabilities for severe toxicity.ConclusionsFocal salvage 125I brachytherapy dominates TS, as it has lower treatment costs and leads to less toxicity in our center. Larger comparative studies with longer follow-up are necessary to assess the exact influence on (biochemical disease free) survival and toxicity.

show abstract

Focal salvage iodine-125 brachytherapy for prostate cancer recurrences after primary radiotherapy: A retrospective study regarding toxicity, biochemical outcome and quality of life

Cited by 85 publications

References 32 publications

Focal or whole-gland salvage prostate brachytherapy with iodine seeds with or without a rectal spacer for postradiotherapy local failure: How best to spare the rectum?

Focal or whole-gland salvage prostate brachytherapy with iodine seeds with or without a rectal spacer for postradiotherapy local failure: How best to spare the rectum?

Multivariable model development and internal validation for prostate cancer specific survival and overall survival after whole-gland salvage Iodine-125 prostate brachytherapy

Comparative cost-effectiveness of focal and total salvage 125 I brachytherapy for recurrent prostate cancer after primary radiotherapy

Contact Info

Product

Resources

About