High-Dose-Rate Brachytherapy Boost for Prostate Cancer: Comparison of Two Different Fractionation Schemes

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• 作者：Tania Kaprealian ; M.D.^&lowast ; ; Vivian Weinberg ; Ph.D.^&dagger ; ; Joycelyn L. Speight ; M.D. ; Ph.D.^&lowast ; ; ^&Dagger ; ; Alexander R. Gottschalk ; M.D. ; Ph.D.^&lowast ; ; Mack Roach III ; M.D.^&lowast ; ; ^&Dagger ; ; Katsuto Shinohara ; M.D.^&Dagger ; ; I.-Chow Hsu ; M.D.^&lowast ; ; ^{IHsu@radonc.ucsf.edu}
• 关键词：Prostate cancer ; High-dose-rate ; Brachytherapy ; Radiation therapy ; Boost
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2012
• 出版时间：1 January 2012
• 年：2012
• 卷：82
• 期：1
• 页码：222-227
• 全文大小：218 K

文摘

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Purpose

This is a retrospective study comparing our experience with high-dose-rate (HDR) brachytherapy boost for prostate cancer, using two different fractionation schemes, 600 cGy ¡Á 3 fractions (patient group 1) and 950 cGy ¡Á 2 fractions (patient group 2).

Methods and Materials

A total of 165 patients were treated for prostate cancer using external beam radiation therapy up to a dose of 45 Gy, followed by an HDR brachytherapy prostate radiation boost. Between July 1997 and Nov 1999, 64 patients were treated with an HDR boost of 600 cGy ¡Á 3 fractions; and between June 2000 and Nov 2005, 101 patients were treated with an HDR boost of 950 cGy ¡Á 2 fractions. All but 9 patients had at least one of the following risk features: pretreatment prostate-specific antigen (PSA) level >10, a Gleason score ?, and/or clinical stage T3 disease.

Results

Median follow-up was 105 months for group 1 and 43 months for group 2. Patients in group 2 had a greater number of high-risk features than group 1 (p = 0.02). Adjusted for comparable follow-up, there was no difference in biochemical no-evidence-of-disease (bNED) rate between the two fractionation scheme approaches, with 5-year Kaplan-Meier estimates of 93.5 % in group 1 and 87.3 % in group 2 (p = 0.19). The 5-year estimates of progression-free survival were 86 % for group 1 and 83 % for group 2 (p = 0.53). Among high-risk patients, there were no differences in bNED or PFS rate due to fractionation.

Conclusions

Results were excellent for both groups. Adjusted for comparable follow-up, no differences were found between groups.