Low-dose rate brachytherapy for men with localized prostate cancer

Peinemann, Frank; Grouven, Ulrich; Hemkens, Lars G.; Bartel, C.; Borchers, Holger; Pinkawa, Michael; Heidenreich, Axel; Sauerland, Stefan

doi:10.1002/14651858.cd008871.pub2

Cited by 28 publications

(12 citation statements)

References 434 publications

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“…Brachytherapy can provide local radiation delivery in or near tumors while potentially minimizing the adverse effects and toxicities (2–4). The response to brachytherapy is quite variable, with 5-year biochemical recurrence-free survival rates ranging from 71% to 96% (3, 4).…”

Section: Introductionmentioning

confidence: 99%

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Recurrent Prostate Cancer Genomic Alterations Predict Response to Brachytherapy Treatment

Fontugne

Lee

Cantaloni

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background This study aimed to evaluate the association of recurrent molecular alterations in prostate cancer, such as ERG rearrangements and phosphatase and tensin homolog gene (PTEN) deletions, with oncologic outcomes in patients with prostate cancer treated with brachytherapy. Methods Ninety-two men underwent I-125 brachytherapy with a 145 Gy delivered dose between 2000 and 2008. Pretreatment prostate biopsies were analyzed by immunohistochemistry (IHC) and FISH for ERG rearrangement and overexpression, PTEN deletion, and expression loss. Univariable and multivariable Cox-regression analyses evaluated association of ERG and PTEN status with biochemical recurrence (BCR). Results Within a median follow-up of 73 months, 11% of patients experienced BCR. Of 80 samples with both IHC and FISH performed for ERG, 46 (57.8%) demonstrated rearrangement by FISH and 45 (56.3%) by IHC. Of 77 samples with both IHC and FISH for PTEN, 14 (18.2%) had PTEN deletion by FISH and 22 (28.6%) by IHC. No significant associations were found between ERG, PTEN status, and clinicopathologic features. Patients with concurrent ERG rearrangement and PTEN deletion demonstrated significantly worse relapse-free survival rates compared with those with ERG or PTEN wild type (P < 0.01). In multivariable Cox regression analysis adjusted for the effects of standard clinicopathologic features, combined ERG rearranged and PTEN deletion was independently associated with BCR (HR = 2.6; P = 0.02). Conclusions Concurrent ERG rearrangement and PTEN loss was independently associated with time to BCR in patients undergoing brachytherapy. Future studies are needed to validate prostate cancer molecular subtyping for risk stratification. Impact Identifying patients in the ERG-rearranged/PTEN-deleted molecular subclass may improve treatment personalization.

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Section: Introductionmentioning

confidence: 99%

“…The response to brachytherapy is quite variable, with 5-year biochemical recurrence-free survival rates ranging from 71% to 96% (3, 4). Preoperative nomograms from large studies (5–8) have helped improve risk stratification significantly.…”

Section: Introductionmentioning

confidence: 99%

Recurrent Prostate Cancer Genomic Alterations Predict Response to Brachytherapy Treatment

Fontugne

Lee

Cantaloni

et al. 2014

Cancer Epidemiology, Biomarkers &Amp; Prevention

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“…There are many treatment modalities for prostate cancer including radical prostatectomy (Roehl et al , 2004), laparoscopic surgery (Touijer et al , 2009), three-dimensional (3D)-conformal radiotherapy (CRT) by photons (Zelefsky et al , 2008), intensity-modulated radiotherapy (IMRT) (Cahlon et al 2008), low-dose rate (LDR) brachytherapy (Peinemann et al , 2011), high-dose rate brachytherapy (Masson et al , 2012), proton beam therapy (Zietman et al , 2010), carbon ion radiotherapy (CIRT) (Ishikawa et al , 2006), hormone therapy (Souhami et al , 2009), and robot-assisted laparoscopic prostatectomy (Menon et al , 2010). A high dose of 78–80 Gy is generally used in 3D-CRT or IMRT for prostate cancer, and definitive radiotherapy using photons or proton beam requires ∼8 weeks (Zelefsky et al , 2008; Cahlon et al 2008; Zietman et al , 2010).…”

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Phase I/II trial of definitive carbon ion radiotherapy for prostate cancer: evaluation of shortening of treatment period to 3 weeks

Nomiya¹,

Tsuji²,

Maruyama³

et al. 2014

Br J Cancer

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Background:The purpose of this study was to evaluate the feasibility of a new shortened 3-week treatment schedule of carbon ion radiotherapy (CIRT) for prostate cancer.Methods:Beginning in May 2010, patients with T1b–T3bN0M0, histologically proven prostate adenocarcinoma were enrolled in the phase II trial of CIRT. Patients received 51.6 GyE in 12 fractions over 3 weeks (protocol 1002). The primary end point was defined as the incidence of late adverse events that were evaluated based on the Common Terminology Criteria for Adverse Events version 4.0. Biochemical failure was determined using the Phoenix definition (nadir +2.0 ng ml−1).Results:Forty-six patients were enrolled, and all patients were included in the analysis. The number of low-, intermediate-, and high-risk patients was 12 (26%), 9 (20%), and 25 (54%), respectively. The median follow-up period of surviving patients was 32.3 months. Two patients had intercurrent death without recurrence, and the remaining 44 patients were alive at the time of this analysis. In the analysis of late toxicities, grade 1 (G1) rectal haemorrhage was observed in 3 (7%) patients. The incidence of G1 haematuria was observed in 6 (13%) patients, and G1 urinary frequency was observed in 17 (37%) patients. No ⩾G2 late toxicities were observed. In the analysis of acute toxicities, 2 (4%) patients showed G2 urinary frequency, and no other G2 acute toxicities were observed.Conclusions:The new shortened CIRT schedule over 3 weeks was considered as feasible. The analysis of long-term outcome is warranted.

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“…The recently published Prostate Cancer Intervention Versus Observation Trial (PIVOT) — a randomised control trial comparing RP with watchful waiting in 731 US patients with localised prostate cancer disease — showed that RP was associated with reduced all‐cause mortality for men with a prostate‐specific antigen (PSA) level greater than 10 ng/mL but that it offered no survival benefit to men with a PSA level of 10 ng/mL or less 5 . A systematic review comparing disease‐free survival for low dose rate brachytherapy with other treatments for men with clinically localised prostate cancer found no significant difference when compared with RP 6 …”

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Patterns of care for men diagnosed with prostate cancer in Victoria from 2008 to 2011

Evans

Millar

Davis

et al. 2013

Medical Journal of Australia

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• 28,405 Victorians were diagnosed with cancer 1 and 10,631 died from cancer in 2011.• The most common new cancers were prostate, breast, bowel, and lung cancers and melanoma.• The leading cancers for mortality were lung, bowel, prostate, breast and pancreatic cancers. NumbersEach year, over 28,000 Victorians develop cancer, other than one of the common skin cancers 1 , and over 10,500 deaths are caused by it. In 2011, 15,695 men and 12,710 women presented with new cancers and 5,921 men and 4,710 women died from cancer. Age and sexCancer was very age-dependent with less than 1% of tumours occurring before age 15 and 58% in persons over 65 years. More men than women developed cancer: 123 for every 100 females. The male excess was largely due to tobacco-related cancers and a large number of prostate cancers.

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Low-dose rate brachytherapy for men with localized prostate cancer

Cited by 28 publications

References 434 publications

Recurrent Prostate Cancer Genomic Alterations Predict Response to Brachytherapy Treatment

Recurrent Prostate Cancer Genomic Alterations Predict Response to Brachytherapy Treatment

Phase I/II trial of definitive carbon ion radiotherapy for prostate cancer: evaluation of shortening of treatment period to 3 weeks

Patterns of care for men diagnosed with prostate cancer in Victoria from 2008 to 2011

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