High Dose-Rate Afterloading
            <sup>192</sup>
            Iridium Prostate Brachytherapy: Feasibility Report

Mate, Timothy P.; Gottesman, Jim; Hatton, Joan; Gribble, Michael; Hollebeke, Lynn Van; Walsh, Patrick C.

doi:10.1016/s0022-5347(05)68365-6

Cited by 31 publications

(50 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Late grade III rectal toxicity was not encountered but grade II was present in 4%. Our results are thus in the range of those found in literature [10,12,13,22,23,32], even if our urinary toxicity was within the less favourable and rectal toxicity within the most favourable results. We did not in fact exclude patients previously treated with TURP and obtained similar toxicity rates as those reporting on similar selection criteria [10].…”

Section: Discussionsupporting

confidence: 83%

192Ir low dose rate brachytherapy for boosting locally advanced prostate cancers after external beam radiotherapy: A phase II trial

Nickers¹,

Coppens

Leval

et al. 2006

Radiotherapy and Oncology

View full text Add to dashboard Cite

Background and purpose: To evaluate on 201 locally advanced prostatic cancers prospectively treated in a phase II trial, the efficacy of a combination of external beam radiotherapy (39.6 Gy) and 192 Ir low dose rate brachytherapy (Bt) (40-45 Gy).Patients and methods: Sixty-four patients were included in the intermediate prognosis group with only one of the following adverse factors (PSAO10 ng/ml, Gleason scoreR7 or clinical stageRT2b) and 137 in the unfavourable group when at least two of these factors were present.Results: The actuarial 4 years biochemical no evidence of disease is 82.8% for the entire population. It is, respectively, 97 and 76% in the intermediate and unfavourable prognosis groups (P!0.0001). GradeR3 late urinary complications occurred in 13 patients (6.5%). Eight patients (4%) presented late grade 2 rectal complications but no grades 3-5 was observed.Conclusions: Even if an a/b of 1.5-3 Gy theoretically favours the use of a high dose rate mode of irradiation, the early results presented here are as good as those reported for similar groups of patients with high dose rate treatments. Late toxicity is identical but our urinary toxicity is within the less favourable and rectal toxicity within the most favourable results.We can postulate that while inducing very high hyperdosage regions (V150) mainly focused on the peripheral zone, most of the Bt techniques consist of a more ablative treatment. Many of the radiobiological studies on Bt did not in fact take into account the heterogeneity of irradiation inside the CTV. This study highlights the need to explore pulsed dose rate therapies, permanent implant and new available radioisotopes such as 169 Ytterbium that will offer the safety of low and lower dose rates. The actual late toxicity of the different Bt techniques is not yet inexistent indeed. q

show abstract

Section: Discussionsupporting

confidence: 83%

192Ir low dose rate brachytherapy for boosting locally advanced prostate cancers after external beam radiotherapy: A phase II trial

Nickers¹,

Coppens

Leval

et al. 2006

Radiotherapy and Oncology

View full text Add to dashboard Cite

show abstract

“…12 Toxicity data from HDR-BT has been well documented. Mate et al 13 recorded that the most common late complication in their patients was the development of urethral stricture. The mean time of onset was 27 months post therapy.…”

Section: The Results Of Hdr Brachytherapymentioning

confidence: 99%

Challenge of dose escalation in locally advanced unfavourable prostate cancer using HDR brachytherapy

Al-Salihi

Mitra

Payne

2006

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

In men with locally advanced/high-risk prostate cancer, there is an ongoing challenge to achieve improved results. Dose escalation studies using three-dimensional conformal radiotherapy (3D-CRT) or intensity modulated radiation therapy (IMRT) have shown benefit particularly in the intermediate and poor risk groups of patients. Of concern, however, is the increase in documented rectal toxicity. High-dose rate brachytherapy (HDR-BT) as a boost in combination with external beam radiotherapy (EBRT) is an alternative strategy of dose escalation that can potentially achieve an even higher biological equivalent dose (BED) to the tumour. The results so far are very encouraging for men with poor prognosis disease. Moreover the technique is associated with very low rates of acute and late toxicity.

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

High Dose-Rate Afterloading ¹⁹² Iridium Prostate Brachytherapy: Feasibility Report

Cited by 31 publications

References 0 publications

192Ir low dose rate brachytherapy for boosting locally advanced prostate cancers after external beam radiotherapy: A phase II trial

192Ir low dose rate brachytherapy for boosting locally advanced prostate cancers after external beam radiotherapy: A phase II trial

Challenge of dose escalation in locally advanced unfavourable prostate cancer using HDR brachytherapy

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

Contact Info

Product

Resources

About

High Dose-Rate Afterloading 192 Iridium Prostate Brachytherapy: Feasibility Report

Cited by 31 publications

References 0 publications

192Ir low dose rate brachytherapy for boosting locally advanced prostate cancers after external beam radiotherapy: A phase II trial

192Ir low dose rate brachytherapy for boosting locally advanced prostate cancers after external beam radiotherapy: A phase II trial

Challenge of dose escalation in locally advanced unfavourable prostate cancer using HDR brachytherapy

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

Contact Info

Product

Resources

About

High Dose-Rate Afterloading ¹⁹² Iridium Prostate Brachytherapy: Feasibility Report