QOL Comparison of Acute Side Effects From a High Dose Rate Vs. Low Dose Rate Prostate Brachytherapy Boost Combined With External Beam Radiotherapy

Rose, Tracey; Garcia, Eleanor; Bachand, François; Kim, David; Petrik, David; Halperin, Ross; Crook, Juanita

doi:10.1016/j.brachy.2015.02.245

Cited by 10 publications

(5 citation statements)

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“…Radiotherapy is aimed at delivering the maximum radiation dose to kill tumor cells with minimal complications to normal tissues. However, normal tissues surrounding cancer cells are inevitably exposed to radiation, leading to early and late effects [32,33]. Peripheral neuropathy, one of the major side effects of radiotherapy, can lead to permanent sensory and motor damage in the upper and lower limbs [2,3,4,8,34,35].…”

Section: Discussionmentioning

confidence: 99%

Histopathological and Functional Evaluation of Radiation-Induced Sciatic Nerve Damage: Melatonin as Radioprotector

et al. 2019

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Background and Objectives: Radiotherapy uses ionizing radiation for cancer treatment. One of the side effects of radiotherapy is peripheral neuropathy. After irradiation, the first stage of neuropathy involves electrophysiological, biochemical and histopathological variations, while the fibrosis of soft tissues surrounding the exposed nerve occurs in the second stage. The present study aimed to examine the radioprotective effects of melatonin against ionizing radiation-induced sciatic nerve damage. Materials and Methods: Sixty male Wistar rats were assigned to four groups: C (Control + Vehicle), M (Melatonin), R (Radiation + Vehicle), MR (Radiation + Melatonin). Their right legs were irradiated with a 30 Gy single dose of gamma rays. Then, 100 mg/kg melatonin was administered to the animals 30 min before irradiation once daily (5 mg/kg) until the day of rats’ sacrifice. Their exposed nerve tissues were assessed using the sciatic functional index (SFI) and histological evaluation. Results: Four, 12 and 20 weeks post irradiation, the SFI results showed that irradiation led to partial loss of motor nerve function after 12 and 20 weeks. Histological evaluation showed the various stages of axonal degeneration and demyelination compared to the C and M groups. Scar-like tissues were detected around the irradiated nerves in the R group at 20 weeks, but were absent in the MR group. The SFI and histological results of the R group showed partial nerve lesion. However, in all cases, treatment with melatonin prevented these effects. Conclusions: Results showed that melatonin has the potential to improve functional and morphological features of exposed sciatic nerves. This could possibly improve the therapeutic window of radiotherapy.

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Section: Discussionmentioning

confidence: 99%

Histopathological and Functional Evaluation of Radiation-Induced Sciatic Nerve Damage: Melatonin as Radioprotector

et al. 2019

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“…In contrast to the increased morbidity demonstrated in ASCENDE-RT, another randomized trial in a similar population of patients did not identify any increased Grade 3 + GU toxicity when using a HDR-BT boost up to 8 years post-treatment (13 % vs 7 %; p = 0.2) [33] . In addition, a study directly comparing HDR-BT versus LDR-BT boost found lower toxicity rates with the former, though this was a small and non-randomized study [47] . A larger, single institutional retrospective review also showed a trend towards lower rates of toxicity with HDR-BT versus LDR-BT boost, though this did not reach statistical significance [48] .…”

Section: Discussionmentioning

confidence: 89%

Does brachytherapy boost improve survival outcomes in Gleason Grade Group 5 patients treated with external beam radiotherapy and androgen deprivation therapy? A systematic review and meta-analysis

Tang¹,

Gulstene²,

McArthur³

et al. 2023

Clinical and Translational Radiation Oncology

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“…There have been no prospective studies comparing these techniques in the reirradiation setting. In the primary treatment setting however prospective and randomised studies have shown HDR-BT to have better quality of life scores compared to LDR-BT in the acute post-treatment phase, particularly in the urinary health domain, which suggests that HDR was better tolerated (64,65). Similarly, evidence from registries and randomised trials of LDR/EBRT combination therapy and HDR/EBRT combination therapy in the primary disease setting suggest that LDR/EBRT might be associated with higher incidence of significant late GU toxicity although no direct comparison has been performed between the two treatments (66)(67)(68).…”

Section: Discussionmentioning

confidence: 99%

“…The median number (range) of included patients for individual BT and SBRT studies was 44 ) and 42 (23-100) respectively. The median age (range) at salvage treatment was 70 years (59)(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76) for BT studies and 74 years (64-78) for SBRT studies. The median PSA at primary treatment for the BT and SBRT studies were 10.9 ng/mL (range 7.4-26.4) and 10.3 ng/ mL (range 8.7-13.0) respectively.…”

Section: Treatment Detailsmentioning

confidence: 99%

Salvage Reirradiation Options for Locally Recurrent Prostate Cancer: A Systematic Review

et al. 2021

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BackgroundReirradiation using brachytherapy (BT) and external beam radiation therapy (EBRT) are salvage strategies with locally radiorecurrent prostate cancer. This systematic review describes the oncologic and toxicity outcomes for salvage BT and EBRT [including Stereotactic Body Radiation Therapy (SBRT)].MethodsAn International Prospective Register of Systematic Reviews (PROSPERO) registered (#211875) study was conducted using Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) guidelines. EMBASE and MEDLINE databases were searched from inception to December 2020. For BT, both low dose rate (LDR) and high dose rate (HDR) BT techniques were included. Two authors independently assessed study quality using the 18-item Modified Delphi technique.ResultsA total of 39 eligible studies comprising 1967 patients were included (28 BT and 11 SBRT). In 35 studies (90%), the design was single centre and/or retrospective and no randomised prospective studies were found. Twelve BT studies used LDR only, 11 HDR only, 4 LDR or HDR and 1 pulsed-dose rate only. All EBRT studies used SBRT exclusively, four with Cyberknife alone and 7 using both Cyberknife and conventional linear accelerator treatments. Median (range) modified Delphi quality score was 15 (6-18). Median (range) follow-up was 47.5 months (13-108) (BT) and 25.4 months (21-44) (SBRT). For the LDR-BT studies, the median (range) 2-year and 5-year bRFS rates were 71% (48-89.5) and 52.5% (20-79). For the HDR-BT studies, the median (range) 2-year and 5-year bRFS rates were 74% (63-89) and 51% (45-65). For the SBRT studies, the median (range) 2-year bRFS for the SBRT group was 54.9% (40-80). Mean (range) acute and late grade≥3 GU toxicity rates for LDR-BT/HDR-BT/SBRT were 7.4%(0-14)/2%(0-14)/2.7%(0-8.7) and 13.6%(0-30)/7.9%(0-21.3%)/2.7%(0-8%). Mean (range) acute and late grade≥3 GI toxicity rates for LDR-BT/HDR-BT/SBRT were 6.5%(0-19)/0%/0.5%(0-4%) and 6.4%(0-20)/0.1%(0-0.9)/0.2%(0-1.5). One third of studies included Patient Reported Outcome Measures (PROMs).ConclusionsSalvage reirradiation of radiorecurrent prostate cancer using HDR-BT or SBRT provides similar biochemical control and acceptable late toxicity. Salvage LDR-BT is associated with higher late GU/GI toxicity. Challenges exist in comparing BT and SBRT from inconsistencies in reporting with missing data, and prospective randomised trials are needed.

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QOL Comparison of Acute Side Effects From a High Dose Rate Vs. Low Dose Rate Prostate Brachytherapy Boost Combined With External Beam Radiotherapy

Cited by 10 publications

References 0 publications

Histopathological and Functional Evaluation of Radiation-Induced Sciatic Nerve Damage: Melatonin as Radioprotector

Histopathological and Functional Evaluation of Radiation-Induced Sciatic Nerve Damage: Melatonin as Radioprotector

Does brachytherapy boost improve survival outcomes in Gleason Grade Group 5 patients treated with external beam radiotherapy and androgen deprivation therapy? A systematic review and meta-analysis

Salvage Reirradiation Options for Locally Recurrent Prostate Cancer: A Systematic Review

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