Salvage high-dose-rate brachytherapy for local recurrence of prostate cancer

Ягудаев, Д. М.; Кадыров, З. А.; Калинин, М. Р.; Беженар, В. А.; Калягина, Н. А.

doi:10.17650/1726-9776-2018-14-2-171-175

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…Несмотря на существующие программы скрининга и стандарты диагностики РПЖ, врачи сталкиваются с ошибками в постановке диагноза и стадировании заболевания [4]. В данном клиническом наблюдении мы хотим показать, что не всегда удается сразу поставить правильный диагноз и выработать верную тактику лечения.…”

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Prostate cancer: from diagnosis to treatment

et al. 2019

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The article presents a complex clinical case of a patient with primary multiple cancer, with lesions of the prostate, bladder, ureter, stomach, regional and distant lymph nodes. Initially, it was assumed that there were four localizations of cancer, but after performing the operation and conducting thorough morphological and immunohistochemical studies, it became possible to prove that only two cancer localizations were present, namely prostate cancer and stomach cancer. The implementation of complex palliative (salvage) surgical interventions as the first stage of the complex treatment of prostate and bladder cancer, as well as the performance of simultaneous operations, can improve the prognosis of patient survival.

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Prostate cancer: from diagnosis to treatment

et al. 2019

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Comparison of salvage high dose-rate brachytherapy and external beam radiotherapy for treatment of prostate cancer local recurrence after radical prostatectomy

2023

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Aim. To compare clinical efficacy of salvage high dose-rate brachytherapy (HDR-BT) and external beam radiotherapy (EBR) in treatment of local recurrence of prostate cancer after radical prostatectomy (RP).Materials and methods. Between January 2017 and December 2020, 60 patients with local recurrence of prostate cancer after RP were treated at the Russian Scientific Center of Roentgenology and Radiology. Two groups were identified: group 1 included 30 patients who underwent salvage external beam radiation therapy (EBRT) according to the classical fractionation regimen; in group 2, within the framework of the scientific protocol, 30 patients underwent 2 fractions of salvage HDR-BT with single boost dose of 15 Gy for total boost dose of 30 Gy. All patients in group 2 underwent pelvic multiparametric magnetic resonance imaging and positron emission tomography-computed tomography with prostatespecific membrane antigen ligands. In the 2nd group, transrectal biopsy of the prostate bed was also performed. Overall and biochemical recurrence-free survival, as well as the profile of early and late radiation complications, were analyzed.Results. Mean age of the patients at the time of salvage radiation therapy was 67.5 years (95 % confidence interval 66.1–69). Median time before development of biochemical relapse after RP was 24 months (interquartile range 13–46 months). Median follow-up period for all patients was 45 months (interquartile range 36–63 months). There were no dropouts in this study. The overall survival rate was 100 % in both groups. Comparative analysis of prostate specific antigen (PSA)-specific recurrence-free survival showed a clear trend toward an increase in the brachytherapy group; however, with the number of observations, statistically significant differences could not be achieved (p = 0.075). Salvage EBRT is more toxic than salvage HDR-BT. Comparative assessment of radiation adverse effects revealed higher frequency of early genitourinary toxicity of grade I and intestinal toxicity of grades I and II in the salvage EBRT group than in the salvage brachytherapy group, as well as late gastrointestinal toxicity of grade I and II.Conclusion. Salvage HDR-BT with 15 Gy × 2 fractions with total boost dose of up to 30 Gy was proved to be a promising treatment for local recurrence of prostate cancer after RP with an acceptable toxicity profile. There was also a trend towards increased PSA-specific recurrence-free survival in the salvage brachytherapy group compared with the salvage EBRT group.

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Clinical use of high dose-rate brachytherapy in treatment of patients with localized prostate cancer and infravesical obstruction

Yagudaev,

Martov,

Ergakov

et al. 2023

Onkourologiâ

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Background. High dose-rate brachytherapy is a new method of interstitial radiation therapy for treatment of localized prostate cancer. The difference from low dose therapy is temporary implantation of radiation sources with targeted high dose-rate irradiation of the affected organ.Aim. To evaluate 3-year effectiveness and safety of high dose-rate brachytherapy in patients with infravesical obstruction. Materials and methods. Between January of 2017 and December of 2019 at the Central Clinical Hospital “RZD-medicine”, 49 patients (mean age 67.8 ± 7.5 years) with verified prostate cancer diagnosis underwent high dose-rate brachytherapy in the regimen of 2 sessions of 15 Gy with 192Ir source. The inclusion criteria were disease stage ≤сТ2с, Gleason score ≤7. Patients were divided into 2 groups: 1st – patients with incidental prostate cancer (n = 21) who previously (more than 6 months ago, mean time 9.4 ± 2.4 months) underwent transurethral prostatectomy; 2nd – patients with verified prostate cancer (mean prostate volume 56 cm3) and obstructive symptoms without previous transurethral prostatectomy (n = 28).Results. In both groups, no intraoperative complications were observed. In 6 (28 %) patients of the 1st group and 2 patients of the 2nd group, grade II genitourinary toxicity in the form of moderate dysuria and nocturia was observed. Acute gastrointestinal toxicity was observed in 3 (14 %) patients of the 1st group, in the 2nd group such complications were absent. In the 2nd group during the postoperative period after the 2nd session, 4 patients (14 %) experienced acute urinary retention requiring cystostomy.Conclusion. High dose-rate brachytherapy is a safe and effective radical treatment method for patients with localized prostate cancer with obstructive symptoms who have contraindications for surgical treatment.

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Salvage high-dose-rate brachytherapy for local recurrence of prostate cancer

Cited by 3 publications

References 11 publications

Prostate cancer: from diagnosis to treatment

Prostate cancer: from diagnosis to treatment

Comparison of salvage high dose-rate brachytherapy and external beam radiotherapy for treatment of prostate cancer local recurrence after radical prostatectomy

Clinical use of high dose-rate brachytherapy in treatment of patients with localized prostate cancer and infravesical obstruction

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