Long-term outcomes in patients younger than 60 years of age treated with brachytherapy for prostate cancer

Prada, Pedro J.; Cardenal, Juan; Blanco, Ana; Anchuelo, J.; Ferri, María; Cerio, I. Diaz de; Vázquez, Andrés; Pacheco, Maite; Arrebola, S. Ruiz

doi:10.1007/s00066-017-1238-2

Cited by 11 publications

(9 citation statements)

References 26 publications

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“…In this study, 2 patients (3.3%) in the combination therapy group, developed rectal hemorrhage as late grade 2 GI toxicity. It was comparable to previous reports of late grade 2 GI toxicity rates of 0.3-1.3% [ 3 , 18 ] in BT monotherapy studies, and 2.8-6.8% [ 8 , 12 ] in the studies including EBRT combination therapy.…”

Section: Discussionsupporting

confidence: 89%

“…There have been no reports about it in combination therapy vs. BT monotherapy. In BT monotherapy, there has been one report of a late hematuria rate of 15.4% [ 17 ], and several reports of late rectal hemorrhage rates of 6-16% [ 3 , 4 , 17 ]. In our study, only one late grade 1 rectal hemorrhage in the monotherapy group was recorded.…”

Section: Discussionmentioning

confidence: 99%

“…Low-dose-rate BT has been shown to be an acceptable, effective, and safe therapy for localized prostate cancer [ 3 ]. This approach has lower complications and is less invasive than RP.…”

Section: Purposementioning

confidence: 99%

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Acute and late toxicities in localized prostate cancer patients treated with low-dose 125I brachytherapy (110 Gy) in combination with external beam radiation therapy versus brachytherapy alone (160 Gy)

Mukai

Hayashi

Koike

et al. 2018

jcb

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PurposeThe aim of this analysis was to compare acute and late toxicities between low-dose-rate brachytherapy (LDR-BT) (110 Gy) in combination with 45 Gy in 25 fractions external beam radiation therapy (EBRT) and LDR-BT (160 Gy) alone for localized prostate cancer.Material and methodsOne hundred five consecutive patients with localized prostate cancer treated from May 2014 to May 2017 were included in this retrospective analysis. Sixty patients received combination therapy and 45 patients received BT monotherapy. The LDR-BT procedure was performed using 125I seeds.ResultsThe median follow-up time was 28 months in both groups. Three-year effect rates were overall survival: 100% in both groups. The biochemical failure rate was 2.3% in the combination group and 0% in the monotherapy group (p = 0.373). No patients died during the study period. In both groups, almost all the patients experienced acute urethritis. There was a significant difference between the combination therapy group (8.3%) and BT monotherapy group (11.1%) in late genitourinary (GU) toxicities ≥ grade 2 (p = 0.035). Only 2 patients (3.3%) in the combination therapy group developed late ≥ grade 2 rectal hemorrhage. There were no significant differences between two groups in hematuria ≥ grade 2 (p = 0.068) or rectal hemorrhage ≥ grade 2 (p = 0.206).ConclusionsTo our knowledge, this is the first report to compare the GU and gastrointestinal toxicities between the combination therapy and BT monotherapy (160 Gy) for localized prostate cancer. Unexpectedly, there were more late GU toxicities (except for hematuria) in the BT monotherapy group.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Acute and late toxicities in localized prostate cancer patients treated with low-dose 125I brachytherapy (110 Gy) in combination with external beam radiation therapy versus brachytherapy alone (160 Gy)

Mukai

Hayashi

Koike

et al. 2018

jcb

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“…For intermediate-risk patients this strict recommendation to perform seeds BT is missing [1]. Nevertheless, numerous studies evaluating the tumor control rates after seeds BT included besides low-risk prostate cancer also intermediate-risk patients and reported excellent tumor control rates [4][5][6][7][8][9][10][11]. However, up to now no randomized trial successfully evaluating the effectiveness of seeds BT compared to EBRT has been published so far.…”

Section: Introductionmentioning

confidence: 99%

Comparison of EBRT and I-125 seed brachytherapy concerning outcome in intermediate-risk prostate cancer

et al. 2021

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Purpose This study’s objective was the comparison of external beam radiotherapy (EBRT) and I‑125 seed brachytherapy regarding clinical outcome and development of side effects. Patients and methods In all, 462 localized intermediate-risk prostate cancer patients treated between 2000 and 2019 at our department using either I‑125 seed brachytherapy or EBRT with a dose of 74 or 78 Gy were included: 297 patients were treated with EBRT and 165 with seeds. Biochemical no evidence of disease (bNED) rates according to Phoenix definition as well as late gastrointestinal and urogenital side effects (EORTC/RTOG) were assessed. Results Patients were followed up yearly with a median follow-up of 54 (3–192) months. Observed bNED rates for 74 Gy, 78 Gy and seeds were 87, 92, and 88% after 5 years and 71, 85, and 76% after 9 years, respectively. No significant differences were found comparing seeds with 74 Gy (p = 0.81) and 78 Gy (p = 0.19), as well as between 74 and 78 Gy (p = 0.32). Concerning gastrointestinal side effects, EBRT showed significantly higher rates of RTOG grade ≥ 2 toxicity compared to seeds, but at no point of the follow-up more than 10% of all patients. However, genitourinary side effects were significantly more prevalent in patients treated with seeds, with 33% RTOG grade ≥ 2 toxicity 12 months after treatment. Nevertheless, both types of side effects decreased over time. Conclusion Favorable intermediate-risk prostate cancer patients can be treated either by external beam radiotherapy (74/78 Gy) or permanent interstitial seed brachytherapy.

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“…Contemporary series examining brachytherapy (BT), indicate excellent cancer-speci c outcomes among younger patients [3][4][5]. Brachytherapy is equally e cient than other interventions (prostatectomy, external beam radiotherapy) but less harmful and is especially attractive for patients with early prostate cancer [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Neurovascular Bundle Preservation With Hyaluronic Acid During Radical Brachytherapy for Localized Prostate Cancer: Technique

Prada¹,

Cardenal²,

Blanco³

et al. 2020

Preprint

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Background: To evaluate the reduction, the absorbed dose delivered to the neurovascular bundle (NB) in patients with localized prostate cancer treated with only HDR brachytherapy and neurovascular bundle protection with Hyaluronic acid (HA) on the side of the prostate to increase the distance from NB to the radioactive sources.Material and Methods: This is the first published report in the medical literature that study a new approach to decrease neurovascular bundle toxicity and improve quality of life for patients with prostate cancer treated with radical brachytherapy as monotherapy. Transperineal HA injection on the side of the prostate into the lateral aspect of the prostate fat was used to consistently displace several autonomic fibres and vessels the lateral wall of the prostate away from radiation sources.Results: When a protection in the form of a HA layer is placed, the reduction effect at the maximum dose is between 46% and 54% (calculated values), which means the method for protection is highly recommended. The values of the absorbed dose calculated in this project have been compared with the ones given by the treatment planning system. These calculated values are similar than the ones given by the treatment planning system (56±2).Conclusions: This newly created space decreases absorbed dose in the neurovascular bundle, calculated with the TPS and measuremed by microMOSFET due to the thickness of HA.

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Long-term outcomes in patients younger than 60 years of age treated with brachytherapy for prostate cancer

Abstract: LDR brachytherapy provides patients younger than 60 years of age with low and intermediate-risk prostate cancer excellent outcomes and has a low risk of significant long-term GU or gastrointestinal morbidity.

Cited by 11 publications

References 26 publications

Acute and late toxicities in localized prostate cancer patients treated with low-dose 125I brachytherapy (110 Gy) in combination with external beam radiation therapy versus brachytherapy alone (160 Gy)

Acute and late toxicities in localized prostate cancer patients treated with low-dose 125I brachytherapy (110 Gy) in combination with external beam radiation therapy versus brachytherapy alone (160 Gy)

Comparison of EBRT and I-125 seed brachytherapy concerning outcome in intermediate-risk prostate cancer

Intraoperative Neurovascular Bundle Preservation With Hyaluronic Acid During Radical Brachytherapy for Localized Prostate Cancer: Technique

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