Intraluminal urethral brachytherapy for recurrence of transitional cell carcinoma of urinary bladder in urethral stump

Abstract

We report a unique case of successfully performed intraluminal brachytherapy for low volume urethral mucosal recurrence of transitional cell carcinoma urinary bladder, initially treated by transurethral resection of bladder tumor, followed by radical cystectomy. Since the patient was unwilling to undergo any other operational interventions, intraluminal brachytherapy of urethra was attempted. Fluroscopy guided intraluminal HDR brachytherapy using Lumencath® catheter under local anesthesia, and remote afterloading system (Nucletron, an Elekta company, Elekta AB, Stockholm, Sweden) was performed. A fraction dose of 7 Gy in seven weekly fractions was prescribed at 0.5 cm from the single applicator. The result was promising in terms of local control and symptomatic relief. Therefore, intraluminal brachytherapy in low volume superficial local disease in urethra may play a potential role, and should be applied when repeated surgery is not feasible due to technical or medical reasons.

External Urethral Orifice Metastasis of Cervical Cancer Treated With Intraluminal Urethral Brachytherapy Using a Lumencath Applicator: The First Case Report

“…There are only two case reports on the use of a Lumencath applicator in intraluminal BT for treating the male urethra. Chakrabarti et al reported complete tumor remission and no sever late toxicity using a fraction dose of 7 Gy in seven weekly fractions was prescribed at 5 mm from the Lumencath applicator [24]. Lewis et al demonstrated intraluminal HDR-BT prescribed with 36 Gy in nine fractions followed by a boost of 24 Gy in six fractions [25].…”

Case reports High-dose-rate brachytherapy – a novel treatment approach for primary clear cell adenocarcinoma of male urethra

“…The dose prescribed was 7 Gy in seven weekly fractions at 0.5 cm from the single applicator. Patient had complete regression of the lesion at 1 year post treatment [ 13 ]. Dalbagni et al .…”

Intraluminal High-Dose-Rate Brachytherapy—An Alternative Organ-Preserving Approach for Primary Male Urothelial Carcinoma With Panurethral Involvement

“…The patient remained asymptomatic and disease-free at a year past treatment. 16 Lewis et al present a case of a male patient with primary clear-cell adenocarcinoma of the urethra treated using intraluminal brachytherapy with 9 daily fractions of 4 Gy each, up to a total radiation dose of 36 Gy. Although the patient was asymptomatic 2 months after treatment, irregular urethral wall thickening was seen in magnetic resonance images, and the patient received an additional dose of 24 Gy divided in 6 fractions of 4 Gy.…”