SP-0350: HDR brachytherapy in one fraction vs LDR brachytherapy in the treatment of localized prostate cancer. Early results

Ágoston, Péter; Major, Tibor; Jorgo, Kliton; Fröhlich, Georgina; Gesztesi, László; Stelczer, Gábor; Polgár, C.

doi:10.1016/s0167-8140(18)30660-1

Cited by 3 publications

(6 citation statements)

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“…Acute grade 2 and grade 3 genitourinary toxicity occurred in 26% and 72% (P < .001) and 2% and 4% of patients treated with HDRB and LDRB, respectively. 51 In contrast, grade 2 urinary, bowel, and sexual toxicities were lower in both arms; no difference was found between the 2 treatment arms, and no grade 3 or 4 toxicity was reported in our present study. As for the mean IPSS at 3 months, it was significantly lower in the HDRB arm (8.9 vs 15.9, P Z .0004), although this difference disappeared at 12 months in the latter study.…”

Section: Discussioncontrasting

confidence: 70%

“…After a median follow-up of 23 months, 4 patients had a biochemical relapse with local failure, 2 patients in each arm. Acute grade 2 and grade 3 genitourinary toxicity occurred in 26% and 72% ( P < .001) and 2% and 4% of patients treated with HDRB and LDRB, respectively 51 . In contrast, grade 2 urinary, bowel, and sexual toxicities were lower in both arms; no difference was found between the 2 treatment arms, and no grade 3 or 4 toxicity was reported in our present study.…”

Section: Discussioncontrasting

confidence: 46%

“…In contrast, grade 2 urinary, bowel, and sexual toxicities were lower in both arms; no difference was found between the 2 treatment arms, and no grade 3 or 4 toxicity was reported in our present study. As for the mean IPSS at 3 months, it was significantly lower in the HDRB arm (8.9 vs 15.9, P = .0004), although this difference disappeared at 12 months in the latter study 51 . In our study, the IPSS was significantly lower in the HDRB group at all time points, including the 12-month mark.…”

Section: Discussioncontrasting

confidence: 44%

“…44 A phase 2 randomized study was presented at the European Society for Radiotherapy and Oncology 2018, reporting on the acute toxicity of LDRB vs HDRB. 51 A total of 100 patients were randomized between LDRB to 145 Gy and single-fraction HDRB of 19 Gy and 21 Gy in 48 and 2 patients, respectively. After a median follow-up of 23 months, 4 patients had a biochemical relapse with local failure, 2 patients in each arm.…”

Section: Discussionmentioning

confidence: 99%

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A Phase 2 Randomized Pilot Study Comparing High-Dose-Rate Brachytherapy and Low-Dose-Rate Brachytherapy as Monotherapy in Localized Prostate Cancer

Hathout

Mahmoud

Wang

et al. 2019

Advances in Radiation Oncology

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PurposeTo compare health-related quality of life (HRQOL) of high-dose-rate brachytherapy (HDRB) versus low dose-rate brachytherapy (LDRB) for localized prostate cancer in a multi-institutional phase 2 randomized trial.Methods and MaterialsMen with favorable-risk prostate cancer were randomized between monotherapy brachytherapy with either Iodine-125 LDRB to 144 Gy or single-fraction Iridium-192 HDRB to 19 Gy. HRQOL and urinary toxicity were recorded at baseline and at 1, 3, 6, and 12 months using the Expanded Prostate Cancer Index Composite (EPIC)-26 scoring and the International Prostate Symptom Score (IPSS). Independent samples t test and mixed effects modeling were performed for continuous variables. Time to IPSS resolution, defined as return to its baseline score ±5 points, was calculated using Kaplan-Meier estimator curves with the log-rank test. A multiple-comparison adjusted P value of ≤.05 was considered significant.ResultsLDRB and HDRB were performed in 15 and 16 patients, respectively, for a total of 31 patients. At 3 months, patients treated with LDRB had a higher IPSS score (mean, 15.5 vs 6.0, respectively; P = .003) and lower EPIC urinary irritative score (mean, 69.2 vs 85.3, respectively; P = .037) compared with those who received HDRB. On repeated measures at 1, 3, 6, and 12 months, the IPSS (P = .003) and EPIC urinary irritative scores (P = .019) were significantly better in the HDR arm, translating into a lower urinary toxicity profile. There were no significant differences in the EPIC urinary incontinence, sexual, or bowel habit scores between the 2 groups at any measured time point. Time to IPSS resolution was significantly shorter in the HDRB group (mean, 2.0 months) compared with the LDRB group (mean, 6.0 months; P = .028).ConclusionsHDRB monotherapy is a promising modality associated with a lower urinary toxicity profile and higher HRQOL in the first 12 months compared with LDRB.

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Section: Discussioncontrasting

confidence: 70%

Section: Discussioncontrasting

confidence: 46%

Section: Discussioncontrasting

confidence: 44%

Section: Discussionmentioning

confidence: 99%

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A Phase 2 Randomized Pilot Study Comparing High-Dose-Rate Brachytherapy and Low-Dose-Rate Brachytherapy as Monotherapy in Localized Prostate Cancer

Hathout

Mahmoud

Wang

et al. 2019

Advances in Radiation Oncology

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“…The prescribed dose was 70 Gy, the dose of the daily fractions was 2.5 Gy for the PTV [22]. The protocol of our PROMOBRA study was applied for treatment planning in both HDR and LDR BT plans [23]. The prescribed dose in HDR BT was 21 Gy (V100 ≥ 95%) to the CTV of the CK plan, as the BT PTV, in a single treatment fraction using Ir-192 radioactive source.…”

Section: Methodsmentioning

confidence: 99%

Comparative dosimetrical analysis of intensity-modulated arc therapy, CyberKnife therapy and image-guided interstitial HDR and LDR brachytherapy of low risk prostate cancer

Fröhlich

Ágoston

Jorgo

et al. 2021

Rep Pract Oncol Radiother.

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background:The objective of the study was to dosimetrically compare the intensity-modulated-arc-therapy (IMaT), cyber-Knife therapy (cK), single fraction interstitial high-dose-rate (hDr) and low-dose-rate (LDr) brachytherapy (BT) in low-risk prostate cancer.Materials and methods: Treatment plans of ten patients treated with cK were selected and additional plans using IMaT, hDr and LDr BT were created on the same cT images. The prescribed dose was 2.5/70 Gy in IMaT, 8/40 Gy in cK, 21 Gy in hDr and 145 Gy in LDr BT to the prostate gland. eQD2 dose-volume parameters were calculated for each technique and compared. results: eQD2 total dose of the prostate was significantly lower with IMaT and cK than with hDr and LDr BT, D90 was 79.5 Gy, 116.4 Gy, 169.2 Gy and 157.9 Gy (p < 0.001). however, teletherapy plans were more conformal than BT, cOIN was 0.84, 0.82, 0.76 and 0.76 (p < 0.001), respectively. The D 2 to the rectum and bladder were lower with hDr BT than

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Low dose rate brachytherapy for primary treatment of localized prostate cancer: A systemic review and executive summary of an evidence-based consensus statement

et al. 2021

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SP-0350: HDR brachytherapy in one fraction vs LDR brachytherapy in the treatment of localized prostate cancer. Early results

Cited by 3 publications

References 0 publications

A Phase 2 Randomized Pilot Study Comparing High-Dose-Rate Brachytherapy and Low-Dose-Rate Brachytherapy as Monotherapy in Localized Prostate Cancer

A Phase 2 Randomized Pilot Study Comparing High-Dose-Rate Brachytherapy and Low-Dose-Rate Brachytherapy as Monotherapy in Localized Prostate Cancer

Comparative dosimetrical analysis of intensity-modulated arc therapy, CyberKnife therapy and image-guided interstitial HDR and LDR brachytherapy of low risk prostate cancer

Low dose rate brachytherapy for primary treatment of localized prostate cancer: A systemic review and executive summary of an evidence-based consensus statement

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