- 作者：Peter Hoskin ; M.D. ; Ana Rojas ; Ph.D. ; arc03@btconnect.com ; Gerry Lowe ; M.Sc. ; Linda Bryant ; D.C.R. (T.) ; Peter Ostler ; F.R.C.R. ; Rob Hughes ; F.R.C.R. ; Jessica Milner ; B.Sc. ; Helen Cladd ; B.Sc.
- 关键词：Dose escalation ; High-dose-rate brachytherapy ; Prostate cancer ; Biochemical relapse ; Morbidity
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2012
- 出版时间：15 March, 2012
- 年：2012
- 卷：82
- 期：4
- 页码：1376-1384
- 全文大小：403 K
Purpose
To evaluate genitourinary (GU) and gastrointestinal (GI) morbidity and biochemical control of disease in patients with localized prostate adenocarcinoma treated with escalating doses per fraction of high-dose rate brachytherapy alone.Methods and Materials
A total of 197 patients were treated with 34 Gy in four fractions, 36 Gy in four fractions, 31.5 Gy in three fractions, or 26 Gy in two fractions. Median follow-up times were 60, 54, 36, and 6 months, respectively.
Results
Incidence of early Grade ?3 GU morbidity was 3 % to 7 % , and Grade 4 was 0 % to 4 % . During the first 12 weeks, the highest mean International Prostate Symptom Score (IPSS) value was 14, and between 6 months and 5 years it was 8. Grade 3 or 4 early GI morbidity was not observed. The 3-year actuarial rate of Grade 3 GU was 3 % to 16 % , and was 3 % to 7 % for strictures requiring surgery (4-year rate). An incidence of 1 % Grade 3 GI events was seen at 3 years. Late Grade 4 GU or GI events were not observed. At 3 years, 99 % of patients with intermediate-risk and 91 % with high-risk disease were free of biochemical relapse (log-rank p?= 0.02).
Conclusions
There was no significant difference in urinary and rectal morbidity between schedules. Biochemical control of disease in patients with intermediate and high risk of relapse was good.