Predictive factors of rectal toxicity after permanent iodine-125 seed implantation: Prospective cohort study in 2339 patients

Abstract

Rectal toxicity was relatively rare in this study compared with previous reports. For Japanese prostate cancer patients, R < 1 mL in both PI and EBRT combination therapy groups and interactive planning in EBRT combination therapy group may be effective in decreasing the incidence of rectal toxicity.

Prediction models for brachytherapy-induced rectal toxicity in patients with locally advanced pelvic cancers: a systematic review

“…The studies were published between 1999 and 2019, with a median sample size of 221 (IQR: 96-617) for cervical cancer and 503 (IQR: 165-2,088) for prostate cancer. The studies were carried out mostly in the United States ( n = 7, 23%) [ 19 , 35 - 37 , 40 , 41 , 47 ], followed by Taiwan ( n = 6, 20%) [ 21 - 23 , 26 , 27 , 29 ], Japan ( n = 5, 17%) [ 25 , 38 , 42 , 44 , 46 ], and South Korea ( n = 4, 13%) [ 28 , 30 , 31 , 43 ].…”

“…Figure 2 shows a summary of the included prediction models. In terms of BT technique, 15 studies performed HDR-BT ( n = 13 cervix, n = 1 prostate, and n = 1 rectal cancer) [ 20 - 23 , 25 - 31 , 33 , 34 , 45 , 48 ], 13 studies used LDR-BT ( n = 12 prostate and n = 1 cervical cancer) [ 19 , 35 - 44 , 46 , 47 ], one study applied PDR-BT for cervical cancer patients [ 32 ], and one study included cervical cancer patients treated with either HDR-BT or LDR-BT [ 24 ]. Two studies (7%) excluded patients who received EBRT [ 39 , 43 ], and 11 studies (37%) included patients who were treated with chemotherapy ( n = 8 concurrent, n = 2 adjuvant, and n = 1 neoadjuvant) [ 19 , 21 - 23 , 26 - 32 ].…”

“…As shown in Table 1 , 16 (54%) studies described prediction models for patients with cervical cancer [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34], and 13 (44%) studies included the prostate cancer patients [35][36][37][38][39][40][41][42][43][44][45][46][47]. Moreover, one study developed a prediction model for elderly inoperable rectal cancer patients [48].…”

Clinical outcomes of 125I brachytherapy with and without external-beam radiation therapy for localized prostate cancer: results from 300 patients at a single institution in Japan

“…The Grade 2 rectal bleeding rate of the combined therapy group was higher than that in previous reports from other institutions in Japan. Katayama et al [ 30 ] reported the incidence of the rectal toxicity in 2339 patients with prostate cancer undergoing 125 I brachytherapy with or without EBRT in a nationwide prospective cohort study in Japan (J-POPS). The 3-year cumulative incidences for ≥Grade 2 rectal toxicity were 2.88%, 1.76% and 6.53% in all subjects, the brachytherapy group and the EBRT combination therapy group, respectively.…”

“…Harada et al [ 34 ] reported that for an RV100 kept below 1.0 ml, no Grade 2 morbidity developed in their study. Based on their results, Katayama et al [ 30 ] proposed that an RV100 of <1 ml in both brachytherapy and EBRT combination therapy groups may be effective in deceasing the incidence of rectal toxicity. Ohashi et al [ 35 ] reported that a rectal dose >160 Gy was correlated with Grade 2 rectal morbidity.…”