Toxicity and quality of life after high-dose-rate brachytherapy as monotherapy for low- and intermediate-risk prostate cancer

Aluwini, S.; Busser, W.; Alemayehu, Wendimagegn; Boormans, Joost L.; Kirkels, Wim J.; Jansen, Peter P.; Praag, J.; Bangma, Chris H.; Kolkman-Deurloo, I.K.K.

doi:10.1016/j.radonc.2015.09.019

Cited by 20 publications

(11 citation statements)

References 39 publications

(53 reference statements)

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“…There are also some data on correlations between dosimetry and urinary changes after HDR monotherapy but these are more limited. Aluwini et al . showed that a higher baseline urinary flow was correlated with lower acute GU toxicity.…”

Section: Discussionmentioning

confidence: 99%

“…21,22 There are also some data on correlations between dosimetry and urinary changes after HDR monotherapy but these are more limited. Aluwini et al 23 showed that a higher baseline urinary flow was correlated with lower acute GU toxicity. In another study from the University of California San Francisco, prostate volume, intraprostatic urethral length and increased V100 to the urethra were predictive of worse quality of life scores.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of patient‐reported acute urinary and sexual toxicity scores in a 6‐ versus 2‐fraction course of high‐dose‐rate prostate brachytherapy monotherapy

Ragab

Banerjee²,

Park

et al. 2017

J Med Imag Rad Onc

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Introduction: To identify differences in acute urinary and sexual toxicity between a 6-fraction and 2-fraction high-dose-rate brachytherapy monotherapy regimen and correlate dosimetric constraints to short-term toxicity. Methods: A single institution retrospective study of 116 men with prostate cancer treated with HDR monotherapy from 2010 to 2015 was conducted. Eighty-one men had 7.25 Gy 9 6-fractions and 35 men had 13.5 Gy 9 2-fractions. Patients had two CT-planned implants spaced 1-2 weeks apart. Patient baseline characteristics, International Prostate Symptom Scores (IPSS) and Sexual Health Inventory for Men (SHIM) scores were collected pre-treatment and 3, 6 and 12 months post-implantation. Mixed effect modelling was undertaken to compare baseline, 1-6 month and 7-12 month scores between groups. Poisson regression analysis was performed to correlate dosimetric constraints with acute toxicity. Results: There was no difference between baseline and post-implantation IPSS scores between 6-fraction and 2-fraction groups. SHIM scores for men treated with 6-fractions had a steeper decline at 1-6 months, but resolved at 7-12 months. Pre-treatment alpha-blocker use correlated with worse shortterm acute urinary toxicity. Worsened SHIM score correlated with increasing age, diabetes mellitus and androgen-deprivation therapy. In a dosimetric analysis of outcomes, prostate V150 dose and bladder wall (D01.cc, D1cc, D2cc) dose correlated with increased IPSS score. Conclusion: No increased acute genitourinary or sexual dysfunction has been observed in men when transitioning from 6-fraction to 2-fraction HDR monotherapy. A dosimetric correlation was found between the V150 and bladder wall doses for acute urinary toxicity. Future research should continue to standardize and validate dose constraints for prostate HDR monotherapy patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of patient‐reported acute urinary and sexual toxicity scores in a 6‐ versus 2‐fraction course of high‐dose‐rate prostate brachytherapy monotherapy

Ragab

Banerjee²,

Park

et al. 2017

J Med Imag Rad Onc

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“…Three large RCTs that were excluded due to staging criteria were the hypofractionated versus conventionally fractionated radiotherapy for patients with localized prostate cancer, Radiation Therapy Oncology Group 92-02, and European Organisation for Research and Treatment of Cancer 22961 trials. [76,94–96] Additionally, we excluded studies with chemotherapy because chemotherapy is mainly used for advanced or metastatic disease. Newer treatments such as proton therapy and stereotactic-body were not included due to lack of comparative evidence on mortality and other patient-centered outcomes.…”

Section: Discussionmentioning

confidence: 99%

Comparative effectiveness of prostate cancer treatments for patient-centered outcomes

et al. 2017

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“…This is primarily due to topographic features of the prostatic urethra located within the prostate gland and, therefore, exposed to radiation in high therapeutic doses. According to the recent reports, the incidence of grade ≥ 2 genitourinary toxicity after HDR brachytherapy for prostate cancer is around 9-10% [ 3 , 10 ], and reaches 12-19% in some publications [ 12 , 13 ]. Therefore, in patients with low risk localized (stage T1-T2a) PCa, the research have been directed toward different methods of focal prostate brachytherapy, which can varied from hemigland irradiation to focal therapy directly to the tumor foci [ 11 , 14 ].…”

Section: Purposementioning

confidence: 99%

Template guided transperineal saturation biopsy of the prostate: lessons for focal and urethra-sparing high-dose-rate brachytherapy for localized prostate cancer

Новиков¹,

Kanaev²,

Novikov³

et al. 2016

jcb

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PurposeThe aim of this work is to evaluate results of prostate transperineal saturation biopsy as a guide for focal high-dose-rate brachytherapy in patients with prostate cancer (PCa).Material and methodsTemplate guided saturation biopsy was performed in 67 primary patients with suspicion for prostate cancer. Biopsy was performed under ultrasonography (US) control with the help of brachytherapy grid and 5 mm distance between samples. We put special attention for accurate sampling of prostate in periurethral region. The number of cores varied from 17 to 81 (average 36 cores). Finally, in 40 patients with confirmed prostate cancer results of biopsy were used for brachytherapy planning.ResultsSaturation biopsy revealed prostate cancer in 40 of 67 evaluated patients. The extent of biopsy core involvement varied from 5% to 100% (average: 57%). Focal nature of PCa (single unilateral tumor nodule) was diagnosed in 10 (25%), multifocal – in another 30 (75%) patients. Hemigland invasion was mentioned in 12 (30%) cases. Saturation biopsy detected PCa in periurethral cores in 27 (67.5%) of 40 evaluated patients. In 10 patients, the extent of involvement in periurethral cores varied between 10% and 50%; in another, 17 observations exceeded 50%. According to results obtained on saturation biopsy, we performed HDR brachytherapy with “urethra low dose tunnel” (D10ur ≤ 80-90%) in 13 patients with noninvolved periurethral cores. Theoretically, hemigland brachytherapy was possible in 12 of 40 evaluated patients with PCa.ConclusionsIn low risk patients with PCa results of template guided saturation biopsy indicates high frequency (75%) of multifocal disease and high probability (67.5%) of periurethral invasion. Suitable candidates for focal HDR brachytherapy or irradiation with additional sparing of urethra can be effectively determined with the help of saturation biopsy.

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Toxicity and quality of life after high-dose-rate brachytherapy as monotherapy for low- and intermediate-risk prostate cancer

Cited by 20 publications

References 39 publications

Comparison of patient‐reported acute urinary and sexual toxicity scores in a 6‐ versus 2‐fraction course of high‐dose‐rate prostate brachytherapy monotherapy

Comparison of patient‐reported acute urinary and sexual toxicity scores in a 6‐ versus 2‐fraction course of high‐dose‐rate prostate brachytherapy monotherapy

Comparative effectiveness of prostate cancer treatments for patient-centered outcomes

Template guided transperineal saturation biopsy of the prostate: lessons for focal and urethra-sparing high-dose-rate brachytherapy for localized prostate cancer

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