The German S3 Guideline Prostate Cancer

Wenz, Frederik; Martin, Thomas J.; Böhmer, Dirk; Martens, Stefan; Sedlmayer, Felix; Wirth, Manfred P.; Miller, Kurt; Heidenreich, Axel; Schrader, Mark; Hinkelbein, W.; Wiegel, Thomas

doi:10.1007/s00066-010-2193-3

Cited by 22 publications

(5 citation statements)

References 40 publications

(42 reference statements)

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“…2,3 There are several curative treatment options for low-and intermediate-risk prostate cancer including radical prostatectomy, external beam radiotherapy (EBRT) or interstitial brachytherapy. 4,5 Low-dose-rate interstitial brachytherapy (LDR brachytherapy) has been shown by many studies to yield excellent patient outcomes in freedom from biochemical recurrence (BCR) with mild side effects. [6][7][8][9][10] This retrospective study reporting a single institution experience aimed to investigate longterm outcome of treatment with interstitial LDR prostate brachytherapy.…”

Section: Introductionmentioning

confidence: 99%

Permanent interstitial low-dose-rate brachytherapy for prostate cancer: institutional experience with implementation and predictive factors for outcome and side effects

Fels,

Okonkwo,

Großmann

et al. 2023

J Radiother Pract

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Introduction: Low-dose-rate brachytherapy (LDR brachytherapy) with Iodine-125-seeds is an established treatment modality for low- and favourable intermediate-risk prostate cancer. Our single institution experience in this field was retrospectively studied. Methods: Two-hundred sixty consecutive patient records were reviewed for demographic, disease, therapy and side effect data. The patients were divided into subgroups by pre- and post-implant prostate-specific antigen (PSA) levels and by different LDR brachytherapy techniques used, that is, preoperative planning technique (PPT) versus intraoperative real-time planning (IOR). Data were analysed by Kaplan–Meier method and appropriate testing was conducted for PSA biochemical recurrence (BCR) and for toxicities. Results: After median follow-up of 65·0 months, 94·0% of all patients were free from BCR. This endpoint showed no significant differences by patient age, initial PSA, PSA decrease over time, Gleason score and implanted total activity. Patients with IOR were free of BCR in 98·9% (180/182) versus 76·9% (40/52) with PPT. All patients with a PSA nadir of <0·1 ng/mL were free from BCR. Six patients (2·5%) reported an incontinence grade 1. Transient nocturia/urge and dysuria appeared in 54·7% and 22·6% of patients. Conclusions: Consistent with literature, LDR brachytherapy for low- and intermediate-risk prostate cancer appeared highly effective for freedom from BCR with mild side effects.

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Section: Introductionmentioning

confidence: 99%

Permanent interstitial low-dose-rate brachytherapy for prostate cancer: institutional experience with implementation and predictive factors for outcome and side effects

Fels,

Okonkwo,

Großmann

et al. 2023

J Radiother Pract

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“…Most the new cases are diagnosed early with low PSA and Gleason scores. For these patients, permanent seed prostate brachytherapy (BT) is a treatment option associated with low morbidity and similar oncological outcome as with radical prostatectomy or external beam radiation therapy [1-3]. For the oncological long-term success of BT, it is important to ensure the prostate is covered with sufficient dose.…”

Section: Introductionmentioning

confidence: 99%

Re-implantation after insufficient primary 125-i permanent prostate brachytherapy

et al. 2013

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IntroductionWe describe five patients receiving a re-implantation (RI) after post-operative dosimetry of the primary 125-I permanent prostate brachytherapy (BT) for prostate cancer revealed an insufficient dose coverage.Materials and methodsFive out of 222 consecutive patients treated (from March, 2001 to August, 2012) with 125-I BT, received a RI after dosimetric verification by CT and MRI fusion four to eight weeks after implantation displayed an insufficient dose coverage. RIs were performed with 10 to 19 seeds, three to four months after primary intervention. Dosimetry after RI showed an improved and sufficient total dose coverage in all patients.ResultsAt last follow-up (18 to 99 months, median 57 months), none of the patients had relevant implant associated side-effects. Functional outcome was comparable to patients after one-time implantation. PSA levels post intervention showed a decreasing tendency in 4 patients. One patient had a local recurrence after 12 months.ConclusionIn our series, approximately 2% of the patients treated with permanent prostate BT required a RI due to insufficient dose coverage. None of the patients who underwent RI experienced complications. Our series, although only with 5 cases and limited follow-up, along with other published reports, demonstrates good tolerability.

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“…Hormone deprivation therapy is therefore used to inhibit further tumour growth, especially in patients with locally advanced or metastatic prostate cancer. Androgen deprivation can be achieved either by surgical or medical castration (see the current German interdisciplinary guideline for the early detection, diagnosis and therapy of the various stages of prostate cancer, September 2009 [2]). A medical standard therapy is the injection of synthetic analogues of gonadotropin-releasing hormone (GnRH; also known as luteinising hormone-releasing hormone, LHRH).…”

Section: Introductionmentioning

confidence: 99%

A 6-month depot formulation of leuprolide acetate is safe and effective in daily clinical practice: a non-interventional prospective study in 1273 patients

Tunn

2011

BMC Urol

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BackgroundTestosterone stimulates growth in many prostate tumours. The established GnRH analogue leuprolide acetate is incorporated in a novel biodegradable polymer matrix (Atrigel® delivery system), that can be administered to reduce testosterone levels in men with advanced hormone-dependent prostate cancer. This novel formulation is available as a 1-, 3- and most recently 6-month depot (Eligard® 45 mg). The latter was shown to lower and maintain safe and effective serum testosterone suppression in a clinical study.MethodsA non-interventional study to confirm the efficacy and safety of 6-monthly leuprolide acetate (Eligard® 45 mg) in routine urological practice was performed in Germany. Data were obtained from 1273 patients under the care of 634 urologists, and were analysed descriptively. Concentrations of PSA and serum testosterone were documented at the baseline visit and at 6 and 12 months following 6-monthly leuprolide acetate. The participating physicians were also asked to assess the efficacy, tolerabilty and handling of 6-monthly leuprolide acetate.ResultsSerum concentrations of PSA and testosterone were decreased substantially within 6 months of initial 6-monthly leuprolide acetate administration. At 12 months, median reductions of 96% (to 0.5 ng/ml) in PSA, and 90% (to 8.9 ng/dl) in serum testosterone, were observed. Further PSA and serum testosterone decreases were also observed in a subpopulation of patients who switched to 6-monthly leuprolide acetate from other GnRH analogues. Physicians rated 6-monthly leuprolide acetate as easy to use, and patients reported good tolerability. Adverse events occurred in 9% of patients; the majority were not serious. In particular, low rates of hot flushes were reported.ConclusionsThis non-interventional study showed that the reliable reduction of PSA and testosterone levels demonstrated in previous clinical studies of twice-yearly leuprolide acetate can also be achieved in routine clinical practice. This study also confirmed good tolerability of 6-monthly leuprolide acetate in routine clinical use and received positive appraisal from physicians.

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The German S3 Guideline Prostate Cancer

Cited by 22 publications

References 40 publications

Permanent interstitial low-dose-rate brachytherapy for prostate cancer: institutional experience with implementation and predictive factors for outcome and side effects

Permanent interstitial low-dose-rate brachytherapy for prostate cancer: institutional experience with implementation and predictive factors for outcome and side effects

Re-implantation after insufficient primary 125-i permanent prostate brachytherapy

A 6-month depot formulation of leuprolide acetate is safe and effective in daily clinical practice: a non-interventional prospective study in 1273 patients

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