Rectal bleeding after high-dose-rate brachytherapy combined with hypofractionated external-beam radiotherapy for localized prostate cancer: Impact of rectal dose in high-dose-rate brachytherapy on occurrence of grade 2 or worse rectal bleeding

Akimoto, Tetsuo; Katoh, Hiroyuki; Kitamoto, Yoshizumi; Tamaki, Tomoaki; Harada, Kosaku; Shirai, Katsuyuki; Nakano, Takashi

doi:10.1016/j.ijrobp.2005.12.017

Cited by 27 publications

(17 citation statements)

References 20 publications

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“…Consequently, the mid-high rectum doses in prostate EBRT are typically managed through constraints on the V 40-75 Gy [28,46] whereas treatments involving prostate brachytherapy (HDR or LDR) should consider the high rectum doses via the V 70%-100% , D 1cc , D 2cc and/or near maximum dose [4,[47][48][49] due to high-dose hot spots associated with radioactive sources. For treatments involving prostate HDR, the importance of low-dose regions has been explained in terms of considerable inter-patient variation in rectal gas and the distance from the prostate to the anterior rectal wall [45]. The instances where the V 80 Gy and V 90 Gy have been identified as important for prostate cancer treatments involving EBRT only were related to homogenous irradiation of volumes with hypofractionated doses [45].…”

Section: Discussionmentioning

confidence: 99%

“…For treatments involving prostate HDR, the importance of low-dose regions has been explained in terms of considerable inter-patient variation in rectal gas and the distance from the prostate to the anterior rectal wall [45]. The instances where the V 80 Gy and V 90 Gy have been identified as important for prostate cancer treatments involving EBRT only were related to homogenous irradiation of volumes with hypofractionated doses [45]. The sections to follow will discuss the findings of this study, summarised in Table 3, relative to findings of the previously mentioned dose-response studies, which are also summarised in Table 3.…”

Section: Discussionmentioning

confidence: 99%

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Prostate external beam radiotherapy combined with high-dose-rate brachytherapy: dose-volume parameters from deformably-registered plans correlate with late gastrointestinal complications

et al. 2016

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Background: Derivation of dose-volume correlated with toxicity for multi-modal treatments can be difficult due to the perceived need for voxel-by-voxel dose accumulation. With data available for a single-institution cohort with long follow-up, an investigation was undertaken into rectal dose-volume effects for gastrointestinal toxicities after deformably-registering each phase of a combined external beam radiotherapy (EBRT)/high-dose-rate (HDR) brachytherapy prostate treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prostate external beam radiotherapy combined with high-dose-rate brachytherapy: dose-volume parameters from deformably-registered plans correlate with late gastrointestinal complications

et al. 2016

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“…High-dose-rate (HDR) brachytherapy for prostate cancer is supplied by two or three implants with a single radiation fraction [1][2][3][4] or by a single implant with one to eight fractions [5][6][7][8][9]. The incidence of urethral stricture is higher in patients with multiple implants with a single fraction than in those with a single implant with multiple fractions [2][3][4][5][6][7][8][9][10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

“…A greater number of implants seem to be correlated with a higher incidence of urethral stricture. However, the incidence of rectal bleeding is higher after a single implant with multiple fractions than after multiple implantations with a single fraction [2][3][4][5][6][7][8][9][10][11][12][13][14][15]. Okamoto et al [16] reported that high, biologically effective doses of HDR brachytherapy plus external-beam radiotherapy (EBRT) to the rectum caused grade 2 rectal bleeding or worse.…”

Section: Introductionmentioning

confidence: 99%

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Radiation dose to rectum in high-dose-rate brachytherapy with a single implant and two fractions for prostate cancer, and its prediction by prostate volume

Shimizu

Noda

Sato

et al. 2014

Radiol Phys Technol

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We aimed to clarify the differences between the estimated rectal dose (ERD) and the first measured dose (FMD) and second measured dose (SMD) to the rectum during high-dose-rate (HDR) brachytherapy, and to predict FMD from the prostate volume (PV) or the rectal dose-volume parameters (RDVPs). ERD, FMD, and SMD were assessed with a rectal dosimeter during HDR brachytherapy of 18 Gy given in two fractions to 110 patients (48 hormone recipients, 62 hormone-naïve patients) with prostate cancer. The correlations between FMD and PV, and between FMD and RDVP (D 2ml-D 5ml) were investigated. ERD (mean ± SD) was 219 ± 44 cGy, FMD was 255 ± 52 cGy, and SMD was 298 ± 63 cGy, which differed significantly (p < 0.001). The correlation coefficients between ERD and FMD, and between FMD and SMD, were 0.82 and 0.78, respectively. SMD was equivalent to 118 ± 16 % FMD. The measured doses were significantly greater in the hormone recipients than in the hormone-naïve patients (p < 0.001). The increase in FMD correlated with the increases in PV and in RDVPs. The correlation coefficients between PV and FMD in all of the patients, in the hormone recipients, and in the hormone-naïve patients were 0.61, 0.64, and 0.64, respectively, whereas that between RDVPs and FMD was <0.53. In conclusion, the dose to the rectum increased with time and was correlated with the increases in PV and RDVPs. The correlation coefficient between FMD and PV was greater than that between FMD and RDVPs.

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Current status and perspectives of brachytherapy for prostate cancer

Yoshioka

2009

Int J Clin Oncol

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Permanent implant brachytherapy (PIB) for prostate cancer in a modern style was introduced in the 1980s. With the excellent outcome, the method prevailed rapidly in the United States in the 1990s, and it has become a standard treatment option at least for low-risk prostate cancer today. In Japan, PIB using (125)I free seeds was started in 2003, and it is being rapidly accepted. About 90 institutions in Japan have already started PIB, and about 10 000 patients have received this treatment during these 5 years. The outcome data for Japanese men should be established, and the efficacy of the combined use of external beam radiation therapy (EBRT) and hormone therapy should be examined. High-dose-rate (HDR) brachytherapy, which has many advantages over PIB, was started in the 1980s, firstly as a boost combined with EBRT, in Europe and the United States. In Japan, combined HDR brachytherapy and EBRT therapy was started in 1994. As for monotherapeutic HDR brachytherapy, the first series in the world was initiated in Osaka, Japan, in 1995. HDR brachytherapy, both as monotherapy and as combined therapy with EBRT, is yielding promising outcomes, and the study of these modalities should be continued. Mutual understanding and cooperation among urologists, radiation oncologists, and medical physicists is essential to enhance brachytherapy for prostate cancer.

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Rectal bleeding after high-dose-rate brachytherapy combined with hypofractionated external-beam radiotherapy for localized prostate cancer: Impact of rectal dose in high-dose-rate brachytherapy on occurrence of grade 2 or worse rectal bleeding

Cited by 27 publications

References 20 publications

Prostate external beam radiotherapy combined with high-dose-rate brachytherapy: dose-volume parameters from deformably-registered plans correlate with late gastrointestinal complications

Prostate external beam radiotherapy combined with high-dose-rate brachytherapy: dose-volume parameters from deformably-registered plans correlate with late gastrointestinal complications

Radiation dose to rectum in high-dose-rate brachytherapy with a single implant and two fractions for prostate cancer, and its prediction by prostate volume

Current status and perspectives of brachytherapy for prostate cancer

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