Iridium-192 Implantation for Node-Negative Carcinoma of the Penis: The Cookridge Hospital Experience

Kiltie, Anne E.; Elwell, Christine; Close, H.J.; Ash, D.

doi:10.1053/clon.2000.9106

Cited by 25 publications

(15 citation statements)

References 19 publications

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“…Both local recurrences and complications, such as soft tissue ulceration increase, have been associated with larger tumor sizes and larger volume implants. [27][28][29] However, Crook et al 30 found no size effect up to 5 cm using a consistent interstitial technique and a narrow range of dose rates between 50 and 60 cGy/h, provided the tumor was limited to the glans. When the tumor is larger than 4 cm and extends beyond the coronal sulcus and onto the shaft, a surgical approach may be preferable.…”

Section: T1g3-4 T≥2mentioning

confidence: 99%

Current Concepts in Penile Cancer

Spiess¹,

Horenblas²,

Pagliaro³

et al. 2013

J Natl Compr Canc Netw

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This review highlights the significant advances made in the diagnosis and management of penile cancer. This often-aggressive tumor phenotype has been characterized by its poor prognosis, mostly attributable to its late presentation and heterogeneity of surgical care because of the paucity of cases treated at most centers. Recent advances in understanding of the risk factors predisposing to penile cancer, including its association with the human papilloma virus (HPV), have brought forth the socioepidemiologic concept of HPV vaccination in certain high-risk populations and countries, which remains highly debated. The management of penile cancer has evolved in recent years with the adoption of penile-sparing and minimally invasive surgical approaches to the inguinal lymph nodes, which are a frequent site of regional spread for this malignancy. Lastly, this review highlights the importance of adopting a multimodal approach consisting of neoadjuvant systemic chemotherapy followed by consolidative surgical resection in patients presenting with bulky/locally advanced nodal metastases from penile cancer.

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Section: T1g3-4 T≥2mentioning

confidence: 99%

Current Concepts in Penile Cancer

Spiess¹,

Horenblas²,

Pagliaro³

et al. 2013

J Natl Compr Canc Netw

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“…Radical BT is a viable option for penile preservation in selected patients with T1-T2 lesions < 4 cm in diameter [ 6 ]. Results of BT for penile carcinoma are most often reported in the form of institutional case series [ 7 , 8 , 9 , 10 , 11 ]. A meta-analysis by Hasan et al .…”

Section: Discussionmentioning

confidence: 99%

Testicular shielding in penile brachytherapy

Bindal¹,

Mahantshetty²,

Tambe

et al. 2015

jcb

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PurposePenile cancer, although rare, is one of the common genitourinary cancers in India affecting mostly aged uncircumcised males. For patients presenting with small superficial lesions < 3 cm restricted to glans, surgery, radical external radiation or brachytherapy may be offered, the latter being preferred as it allows organ and function preservation. In patients receiving brachytherapy, testicular morbidity is not commonly addressed. With an aim to minimize and document the doses to testis after adequate shielding during radical interstitial brachytherapy for penile cancers, we undertook this study in 2 patients undergoing brachytherapy and forms the basis of this report.Material and methodsTwo patients with early stage penile cancer limited to the glans were treated with radical high-dose-rate (HDR) brachytherapy using interstitial implant. A total of 7-8 tubes were implanted in two planes, parallel to the penile shaft. A total dose of 44-48 Gy (55-60 Gy EQD2 doses with α/β = 10) was delivered in 11-12 fractions of 4 Gy each delivered twice daily. Lead sheets adding to 11 mm (4-5 half value layer) were interposed between the penile shaft and scrotum. The testicular dose was measured using thermoluminescent dosimeters. For each patient, dosimetry was done for 3 fractions and mean calculated.ResultsThe cumulative testicular dose to left and right testis was 31.68 cGy and 42.79 cGy for patient A, and 21.96 cGy and 23.28 cGy for patient B. For the same patients, the mean cumulative dose measured at the posterior aspect of penile shaft was 722.15 cGy and 807.72 cGy, amounting to 16.4% and 16.8% of the prescribed dose. Hence, the application of lead shield 11 mm thick reduced testicular dose from 722-808 cGy to 21.96-42.57 cGy, an “absolute reduction” of 95.99 ± 1.5%.ConclusionsWith the use of a simple lead shield as described, we were able to effectively reduce testicular dose from “spermicidal” range to “oligospermic” range with possible reversibility.

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“…[ 32 ] Retrospective series from 1984 to 2009 demonstrate 5-year local control ranging from 70% to 87% and 5-year cancer-specific survival of 72%–88%. [ 32 37 38 ] Penile preservation at 5 and 10 years was 74%–88% and 67%–70%, respectively. Treatment failure was correlated with tumor size >4 cm and insufficient needle spacing.…”

Section: Radiation Therapymentioning

confidence: 99%

“…Treatment failure was correlated with tumor size >4 cm and insufficient needle spacing. [ 1 2 3 32 37 38 ]…”

Section: Radiation Therapymentioning

confidence: 99%

Penile-sparing modalities in the management of low-stage penile cancer

et al. 2018

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Penile-sparing modalities are gaining widespread adoption for the management of low-stage penile cancer due to an increasing demonstration of sound oncologic, cosmetic, sexual, psychosocial, and quality of life outcomes. This review aims to provide a comprehensive overview of the respective treatment options in the armamentarium of the practicing urologist in dealing with this rare but problematic condition.

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Iridium-192 Implantation for Node-Negative Carcinoma of the Penis: The Cookridge Hospital Experience

Cited by 25 publications

References 19 publications

Current Concepts in Penile Cancer

Current Concepts in Penile Cancer

Testicular shielding in penile brachytherapy

Penile-sparing modalities in the management of low-stage penile cancer

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