Treatment-related symptoms during the first year following transperineal 125I prostate implantation

Kleinberg, Lawrence; Wallner, Kent E.; Roy, Jitendra Nath; Zeléfsky, Michael J.; Arterbery, V. Elayne; Fuks, Zvi; Harrison, Louis B.

doi:10.1016/0360-3016(94)90119-8

Cited by 124 publications

(34 citation statements)

References 11 publications

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“…24 This subsequently decreased to approximately 1% in their later reports, presumably as they gained experience. 30 The incidence of rectal fistulas in other early series varied from <1% to 7%, 24,[31][32][33][34][35][36] and the overall average incidence was 2.6%. In more contemporary series, the rates of rectal fistula have been between 0% and 1%.…”

Section: Incidence Of Late Rectal Complicationsmentioning

confidence: 93%

Late rectal complications after prostate brachytherapy for localized prostate cancer

Phan¹,

Swanson²,

Levy³

et al. 2009

Cancer

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This review of the literature on late rectal complications after prostate brachytherapy indicated that it is a highly effective treatment modality for patients with clinically localized prostate cancer but can cause chronic radiation proctitis. The most common manifestation of chronic radiation proctitis was anterior rectal wall bleeding, which often occurred within the first 2 years after brachytherapy. It is interesting to note that the rates of late rectal morbidity appear to have declined over time, which may reflect improvements in implantation techniques and imaging. Rectal biopsy as part of the workup to evaluate rectal bleeding can lead to rectal fistula and the need for colostomy, a rare but major complication. The authors recommend 1) screening colonoscopy before brachytherapy for patients who have not had a screening colonoscopy within the preceding 3 years to rule out colorectal malignancies and, thus, facilitate conservative management should rectal bleeding occur; 2) lifestyle modifications during treatment to limit exposure of the rectum to radiation; and 3) conservative management for rectal bleeding that occurs within 2 years after brachytherapy. Prostate cancer is the leading cause of cancer in men and accounts for approximately 33% of cancer deaths among men in the US.1,2 Management options for organ-confined, low-to intermediate-risk prostate cancer include watchful waiting, radical prostatectomy, external-beam radiation therapy, and prostate brachytherapy with permanent interstitial implants. Recent improvements in radioactive seed implantation techniques have established prostate brachytherapy as a highly effective treatment modality for localized prostate cancer, with long-term local and biochemical control similar to outcomes observed after radical prostatectomy and external-beam radiation therapy. 3,4 Because prostate cancer is diagnosed

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Section: Incidence Of Late Rectal Complicationsmentioning

confidence: 93%

Late rectal complications after prostate brachytherapy for localized prostate cancer

Phan¹,

Swanson²,

Levy³

et al. 2009

Cancer

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“…Although much has been written about postimplant urinary morbidity, which affects nearly all patients to some degree, there are relatively little data regarding rectal morbidity [3][4][5][6][7][8]. Considering that rates of radiation proctitis have been consistently reported to be in the 1% to 9% range, more information regarding rectal morbidity and dosi-metric parameters is needed.…”

Section: Introductionmentioning

confidence: 99%

Dosimetric and radiographic correlates to prostate brachytherapy‐related rectal complications

Han

Wallner

2001

Intl Journal of Cancer

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SUMMARY Despite rates of radiation proctitis reported in the 1% to 9% range in most series, there is little information regarding rectal morbidity and dosimetric parameters. Accordingly, we have analyzed computed tomography (CT)-based dosimetric parameters based on a series of patients with endoscopically proven radiation proctitis. Nine patients diagnosed with radiation proctitis on endoscopy were identified in a prior review of 160 consecutively treated patients at the University of Washington in 1997. For each proctitis patient, two patients with no rectal bleeding matched for prostate size, isotope, and dose were selected as controls. Axial CT images obtained 2 to 4 hour postoperatively were used for postimplant dosimetry. Dose volume histograms of the rectum, surface area of the outer rectal wall receiving ≥ 100% of the prescribed dose, maximum rectal dose, and length of rectum receiving ≥ 100% prescription were obtained. Preimplant CT scans were used to group patients into three categories based on the amount of apparent rectal contact with the prostate. All rectal dosimetric parameters were statistically different between patients with or without rectal bleeding. The mean surface area receiving at least 100% prescription dose was 3.1 cm 2 for the controls vs. 6.9 cm 2 for the rectal bleeders (P = 0.001). The volume of rectum receiving at least 100% of prescription dose was 0.6 cc for the controls vs. 2.5 cc for the bleeders (P = 0.00008). Patients with full prostate-rectal contact had significantly higher rectal dose parameters compared to those with partial or no rectal contact. All nine proctitis patients were in the full-rectal-contact group compared to only seven of 18 (39%) controls. This detailed dosimetric analysis shows higher rectal doses for patients with radiation proctitis, making it a potential method of identifying patients at higher risk for receiving excessive rectal doses based on the anatomic relationship between the rectum and prostate on CT scan. Published 2001 Wiley-Liss, Inc. †

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“…Urinary or rectal complication and sexual dysfunction are generally reported to be relative low in many recent studies. [34][35][36][37][38][39] Careful treatment planning and execution are expected to further reduce treatment-related morbidities.…”

Section: Introductionmentioning

confidence: 99%

Permanent prostate seed implant brachytherapy: Report of the American Association of Physicists in Medicine Task Group No. 64

et al. 1999

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There is now considerable evidence to suggest that technical innovations, 3D image-based planning, template guidance, computerized dosimetry analysis and improved quality assurance practice have converged in synergy in modern prostate brachytherapy, which promise to lead to increased tumor control and decreased toxicity. A substantial part of the medical physicist's contribution to this multi-disciplinary modality has a direct impact on the factors that may singly or jointly determine the treatment outcome. It is therefore of paramount importance for the medical physics community to establish a uniform standard of practice for prostate brachytherapy physics, so that the therapeutic potential of the modality can be maximally and consistently realized in the wider healthcare community. A recent survey in the U.S. for prostate brachytherapy revealed alarming variance in the pattern of practice in physics and dosimetry, particularly in regard to dose calculation, seed assay and time/method of postimplant imaging. Because of the large number of start-up programs at this time, it is essential that the roles and responsibilities of the medical physicist be clearly defined, consistent with the pivotal nature of the clinical physics component in assuring the ultimate success of prostate brachytherapy. It was against this background that the Radiation Therapy Committee of the American Association of Physicists in Medicine formed Task Group No. 64, which was charged ͑1͒ to review the current techniques in prostate seed implant brachytherapy, ͑2͒ to summarize the present knowledge in treatment planning, dose specification and reporting, ͑3͒ to recommend practical guidelines for the clinical medical physicist, and ͑4͒ to identify issues for future investigation.

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Treatment-related symptoms during the first year following transperineal 125I prostate implantation

Cited by 124 publications

References 11 publications

Late rectal complications after prostate brachytherapy for localized prostate cancer

Late rectal complications after prostate brachytherapy for localized prostate cancer

Dosimetric and radiographic correlates to prostate brachytherapy‐related rectal complications

Permanent prostate seed implant brachytherapy: Report of the American Association of Physicists in Medicine Task Group No. 64

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