Long-term outcome of high dose rate brachytherapy in radiotherapy of localised prostate cancer

Åström, Lennart; Pedersen, Dorte; Mercke, Claes; Holmäng, Sten; Johansson, K.-A.

doi:10.1016/j.radonc.2004.10.014

Cited by 124 publications

(41 citation statements)

References 15 publications

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“…These observations led to use of high dose rate brachytherapy (HDR), first as a boost [17][18][19], and then as definitive monotherapy [20][21][22][23]. Due to its superior conformality, HDR could deliver high bioequivalent doses while sparing neighboring critical structures.…”

Section: Introductionmentioning

confidence: 99%

Hypofractionated SBRT Versus Conventionally Fractionated EBRT for Prostate Cancer: Comparison of PSA Slope and Nadir

Anwar

Weinberg

Chang

et al. 2013

International Journal of Radiation Oncology*Biology*Physics

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Background: Patients with early stage prostate cancer have a variety of curative radiotherapy options, including conventionally-fractionated external beam radiotherapy (CF-EBRT) and hypofractionated stereotactic body radiotherapy (SBRT). Although results of CF-EBRT are well known, the use of SBRT for prostate cancer is a more recent development, and long-term follow-up is not yet available. However, rapid post-treatment PSA decline and low PSA nadir have been linked to improved clinical outcomes. The purpose of this study was to compare the PSA kinetics between CF-EBRT and SBRT in newly diagnosed localized prostate cancer. Materials/methods: 75 patients with low to low-intermediate risk prostate cancer (T1-T2; GS 3 + 3, PSA < 20 or 3 + 4, PSA < 15) treated without hormones with CF-EBRT (>70.2 Gy, <76 Gy) to the prostate only, were identified from a prospectively collected cohort of patients treated at the University of California, San Francisco (1997. Patients were excluded if they failed therapy by the Phoenix definition or had less than 1 year of follow-up or <3 PSAs. 43 patients who were treated with SBRT to the prostate to 38 Gy in 4 daily fractions also met the same criteria. PSA nadir and rate of change in PSA over time (slope) were calculated from the completion of RT to 1, 2 and 3 years post-RT.

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Section: Introductionmentioning

confidence: 99%

Hypofractionated SBRT Versus Conventionally Fractionated EBRT for Prostate Cancer: Comparison of PSA Slope and Nadir

Anwar

Weinberg

Chang

et al. 2013

International Journal of Radiation Oncology*Biology*Physics

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“…In the above-quoted randomized studies, however, late toxicity rates have been higher for patients treated in the high-dose arms either at the level of the rectum (8,9) or at the level of the bladder/urethra (7). To reduce dose-limiting side effects, several authors have devised dose escalation protocols using standard fractionated RT with intensity-modulated radiotherapy (IMRT) with X-ray beams (10) or hypofractionated RT either with IMRT (11) or high-dose rate brachytherapy (HDR-BT) (12)(13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Hypofractionated Boost to the Dominant Tumor Region With Intensity Modulated Stereotactic Radiotherapy for Prostate Cancer: A Sequential Dose Escalation Pilot Study

Miralbell¹,

Mollà²,

Rouzaud

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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“…[27][28][29] Indeed , IMRT and HDR brachytherapy with hypofractionation have yielded desirable outcomes for prostate cancer with comparable morbidity rates to high-dose three-dimensional conformal RT (3D-CRT) with conventional fractionation. [20][21][22][23][24][25][26][27][28][29][30][31][32] Kupelian et al 30 recently reported that the long-term outcomes of hypofractionated IMRT with a total dose of 70 Gy in 28 fractions with a fractional dose of 2.5 Gy was at least equivalent to those with 81 Gy given in 45 fractions as reported by Zelefsky et al 33 In their study, Grade 2 or severe late rectal toxicity was observed in just 5% of patients at the last follow up. Therefore, the results of the study support that the use of modern RT modalities, such as IMRT, HDR and charged particle radiotherapy, which can provide a welllocalized dose to the target, can minimize rectal toxicity even when a hypofractionated regimen is applied.…”

Section: Benefit Of Hypofractionated Radiotherapy For Prostate Cancermentioning

confidence: 88%

Carbon‐ion radiation therapy for prostate cancer

Ishikawa

Tsuji²,

Kamada³

et al. 2012

Int J of Urology

104

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Abbreviations & Acronyms ADT = androgen deprivation therapy bNED = biological relapse free C-ion RT = carbon-ion radiotherapy CSS = cause-specific survival CT = computed tomography CTV = clinical target volume 3D-CRT = three-dimensional conformal radiation therapy DVH = dose-volume histogram Fr = fractions GHMC = Gunma Heavy Ion Medical Center GI = gastrointestinal GS = Gleason score GU = genitourinary Gy = gray GyE = gray equivalents HAMT = Highly Advanced Medical Technology HDR = high-dose-rate HIMAC = Heavy-Ion Medical Accelerator in Chiba IMRT = intensity modulated radiotherapy iPSA = initial serum prostate-specific antigen LET = linear energy transfer L/Q = linear-quadratic NIRS = National Institute of Radiological Sciences PSA = prostate-specific antigen PTV1 = initial planning target volume PTV2 = second planning target volume RBE = relative biological effectiveness RT = radiation therapy RTOG = Radiation Therapy Oncology Group SBRT = stereotactic body radiotherapy SOBP = spread-out Bragg peak UICC = Union for International Cancer Control Abstract: In 1994, carbon-ion radiotherapy was started at the National Institute of Radiological Sciences using the Heavy-Ion Medical Accelerator in Chiba. Between June 1995 and March 2000, two phase I/II dose escalation studies (protocols 9402 and 9703) of hypofractionated carbon-ion radiotherapy for both early-and advance-stage prostate cancer patients had been carried out to establish radiotherapy technique and to determine the optimal radiation dose. To validate the feasibility and efficacy of hypofractionated carbon-ion radiotherapy, a phase II study (9904) was initiated in April 2000 using the shrinking field technique and the recommended dose fractionation (66 gray equivalents in 20 fractions over 5 weeks) obtained from the phase I/II studies, and was successfully completed in October 2003. The data from 175 patients in the phase II study showed the importance of an appropriate use of androgen deprivation therapy according to tumor risk group. Since November 2003, carbon-ion radiotherapy for prostate cancer was approved as "Highly Advanced Medical Technology" from the Ministry of Health, Labor, and Welfare, and since then approximately 1100 patients have received carbon-ion radiotherapy as of July 2011. In this review, we introduce our steps thorough three clinical trials carried out at National Institute of Radiological Sciences, and show the updated data of carbon-ion radiotherapy obtained from approximately 1000 prostate cancer patients. In addition, our recent challenge and future direction will be also described.

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Long-term outcome of high dose rate brachytherapy in radiotherapy of localised prostate cancer

Cited by 124 publications

References 15 publications

Hypofractionated SBRT Versus Conventionally Fractionated EBRT for Prostate Cancer: Comparison of PSA Slope and Nadir

Hypofractionated SBRT Versus Conventionally Fractionated EBRT for Prostate Cancer: Comparison of PSA Slope and Nadir

Hypofractionated Boost to the Dominant Tumor Region With Intensity Modulated Stereotactic Radiotherapy for Prostate Cancer: A Sequential Dose Escalation Pilot Study

Carbon‐ion radiation therapy for prostate cancer

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