High-dose-rate interstitial brachytherapy in combination with androgen deprivation therapy for prostate cancer

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• 作者：Ken Yoshida M.D. (1)
  Hideya Yamazaki M.D. (2)
  Tadashi Takenaka R.T.T (3)
  Tadayuki Kotsuma M.D. (4)
  Mineo Yoshida M.D. (4)
  Koji Masui M.D. (2)
  Yasuo Yoshioka M.D. (5)
  Yoshifumi Narumi M.D. (1)
  Toshitsugu Oka M.D. (6)
  Eiichi Tanaka M.D. (4)
  
• 关键词：Survival ; Radiotherapy ; Quality of life ; Toxicity ; Monotherapy ; überleben ; Radiotherapie ; Lebensqualit?t ; Toxizit?t ; Monotherapie
• 刊名：Strahlentherapie und Onkologie
• 出版年：2014
• 出版时间：October 2014
• 年：2014
• 卷：190
• 期：11
• 页码：1015-1020
• 全文大小：373 KB
• 参考文献：1. Barkati M, Williams SG, Foroudi F et al (2012) High-dose-rate brachytherapy as a monotherapy for favorable-risk prostate cancer: a Phase II trial. Int J Radiat Oncol Biol Phys 82:1889-896 CrossRef
  2. Challapalli A, Jones E, Harvey C et al (2012) High dose rate prostate brachytherapy: an overview of the rationale, experience and emerging applications in the treatment of prostate cancer. Br J Radiol 85:18-7 CrossRef
  3. Demanes DJ, Martinez AA, Ghilezan M et al (2011) High-dose-rate monotherapy: safe and effective brachytherapy for patients with localized prostate cancer. Int J Radiat Oncol Biol Phys 81:1286-292 CrossRef
  4. Galalae RM, Kovacs G, Schultze J et al (2002) Long-term outcome after elective irradiation of the pelvic lymphatics and local dose escalation using high-dose-rate brachytherapy for locally advanced prostate cancer. Int J Radiat Oncol Biol Phys 52:81-0 CrossRef
  5. Ghadjar P, Keller T, Rentsch CA et al (2009) Toxicity and early treatment outcomes in low- and intermediate-risk prostate cancer managed by high-dose-rate brachytherapy as a monotherapy. Brachytherapy 8:45-1 CrossRef
  6. Grills IS, Martinez AA, Hollander M et al (2004) High dose rate brachytherapy as prostate cancer monotherapy reduces toxicity compared to low dose rate palladium seeds. J Urol 171:1098-104 CrossRef
  7. Hoskin P, Rojas A, Lowe G et al (2012) High-dose-rate brachytherapy alone for localized prostate cancer in patients at moderate or high risk of biochemical recurrence. Int J Radiat Oncol Biol Phys 82:1376-384 CrossRef
  8. Jacob R, Hanlon AL, Horwitz EM et al (2005) Role of prostate dose escalation in patients with greater than 15 % risk of pelvic lymph node involvement. Int J Radiat Oncol Biol Phys 61:695-01 CrossRef
  9. Komiya A, Fujiuchi Y, Ito T et al (2013) Early quality of life outcomes in patients with prostate cancer managed by high-dose-rate brachytherapy as monotherapy. Int J Urol 20:185-92 CrossRef
  10. Kovács G, P?tter R, Loch T et al (2005) GEC/ESTRO-EAU recommendations on temporary brachytherapy using stepping sources for localised prostate cancer. Radiother Oncol 74:137-48 CrossRef
  11. Krauss DJ (2013) HDR brachytherapy alone for high-risk prostate cancer: a safe approach for patients with localized disease? Int J Radiat Oncol Biol Phys 85:1161-162 CrossRef
  12. Lawton CA, DeSilvio M, Roach M 3rd et al (2007) An update of the phase III trial comparing whole pelvic to prostate only radiotherapy and neoadjuvant to adjuvant total androgen suppression: updated analysis of RTOG 94-3, with emphasis on unexpected hormone/radiation interactions. Int J Radiat Oncol Biol Phys 69:646-55 CrossRef
  13. Martin T, Baltas D, Kurek R et al (2004) 3-D conformal HDR brachytherapy as monotherapy for localized prostate cancer. A pilot study. Strahlenther Onkol 180:225-32 CrossRef
  14. Martinez A, Pataki I, Edmundson G et al (2001) Phase II prospective study of the use of conformal high-dose-rate brachytherapy as monotherapy for the treatment of favorable stage prostate cancer: a feasibility report. Int J Radiat Oncol Biol Phys 49:61-9 CrossRef
  15. Mate TP, Gottesman JE, Hatton J et al (1998) High dose-rate afterloading Ir-192 pro
• 作者单位：Ken Yoshida M.D. (1)
  Hideya Yamazaki M.D. (2)
  Tadashi Takenaka R.T.T (3)
  Tadayuki Kotsuma M.D. (4)
  Mineo Yoshida M.D. (4)
  Koji Masui M.D. (2)
  Yasuo Yoshioka M.D. (5)
  Yoshifumi Narumi M.D. (1)
  Toshitsugu Oka M.D. (6)
  Eiichi Tanaka M.D. (4)
  
  1. Department of Radiology, Osaka Medical College, 2-, Daigaku-machi, 569-8686, Takatsuki, Osaka, Japan
  2. Department of Radiology, Kyoto Prefectural University of Medicine, 465, Kajiicho, Kawaramachi Hirokoji, Kamigyo-ku, 602-8566, Kyoto, Japan
  3. Department of Radiology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, 540-0006, Osaka city, Osaka, Japan
  4. Department of Radiation Oncology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, 540-0006, Osaka city, Osaka, Japan
  5. Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, 565-0871, Suita, Osaka, Japan
  6. Department of Urology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, 540-0006, Osaka city, Osaka, Japan
  
• ISSN：1439-099X

文摘

Background and purpose To evaluate the effectiveness of high-dose-rate interstitial brachytherapy (HDR-ISBT) as the only form of radiotherapy for high-risk prostate cancer patients. Patients and methods Between July 2003 and June 2008, we retrospectively evaluated the outcomes of 48?high-risk patients who had undergone HDR-ISBT at the National Hospital Organization Osaka National Hospital. Risk group classification was according to the criteria described in the National Comprehensive Cancer Network (NCCN) guidelines. Median follow-up was 73?months (range?12-09?months). Neoadjuvant androgen deprivation therapy (ADT) was administered to all 48?patients; 12?patients also received adjuvant ADT. Maximal androgen blockade was performed in 37?patients. Median total treatment duration was 8?months (range?3-5?months). The planned prescribed dose was 54?Gy in 9?fractions over 5?days for the first 13?patients and 49?Gy in 7?fractions over 4?days for 34?patients. Only one patient who was over 80?years old received 38?Gy in 4?fractions over 3?days. The clinical target volume (CTV) was calculated for the prostate gland and the medial side of the seminal vesicles. A 10-mm cranial margin was added to the CTV to create the planning target volume (PTV). Results The 5-year overall survival and biochemical control rates were 98?and 87-, respectively. Grade?3 late genitourinary and gastrointestinal complications occurred in 2?patients (4-) and 1?patient (2-), respectively; grade?2 late genitourinary and gastrointestinal complications occurred in 5??patients (10-) and 1?patient (2-), respectively. Conclusion Even for high-risk patients, HDR-ISBT as the only form of radiotherapy combined with ADT achieved promising biochemical control results, with acceptable late genitourinary and gastrointestinal complication rates.