- 作者：Marisa A. Kollmeier<sup>1sup><sup> ; sup><sup>kollmeim@mskcc.orgsup> ; Xin Pei<sup>1sup> ; Ece Algur<sup>1sup> ; Yoshiya Yamada<sup>1sup> ; Brett W. Cox<sup>1sup> ; Gil’ ; ad N. Cohen<sup>2sup> ; Marco Zaider<sup>2sup> ; Michael J. Zelefsky<sup>1sup>
- 关键词：Iodine-125 ; Palladium-103 ; External beam radiation therapy ; Prostate cancer ; Brachytherapy
- 刊名：Brachytherapy
- 出版年：2012
- 期刊代码：278_15384721
- 类别：med
- 出版时间：July-August, 2012
- 卷：11
- 期：4
- 页码：271-276
- 文件大小：201 K
ss="h4">Purpose
To compare biochemical outcomes and morbidity associated with iodine-125 (<sup>125sup>I) and palladium-103 (<sup>103sup>Pd) brachytherapy as part of combined modality therapy for clinically localized prostate cancer.ss="h4">Methods and Materials
Between October 2002 and December 2008, 259 patients underwent prostate brachytherapy (<sup>125sup>I prescription dose, 110 Gy: n = 199; <sup>103sup>Pd prescription dose, 100 Gy: n = 60) followed by external beam radiotherapy (median dose, 50.4 Gy). Eighty-seven patients also received neoadjuvant androgen deprivation therapy. Toxicities were recorded with CTCAE v 3.0, International Prostate Symptoms Score (IPSS), and International Index of Erectile Function questionnaires.
ss="h4">Results
Overall, acute Grade 鈮? genitourinary toxicity occurred in 21%and 30%of patients treated with <sup>125sup>I and <sup>103sup>Pd, respectively (p = 0.16). There were no significant differences in IPSS change or urinary quality-of-life scores between the isotopes at 4, 6, or 12 months (p = 0.20, 0.21, and 1.0, respectively). IPSS resolution occurred at a median of 11 and 6 months for <sup>125sup>I and <sup>103sup>Pd patients, respectively (p = 0.03). On multivariate analysis, only the use of neoadjuvant androgen deprivation therapy was predictive of time to IPSS resolution (p = 0.046). Late Grade 鈮? gastrointestinal toxicity occurred in 7%of <sup>125sup>I patients and 6%of patients treated with <sup>103sup>Pd. Of 129 potent patients at baseline, there was better erectile function in patients who received <sup>103sup>Pd (p = 0.02); however, the followup was shorter for these patients. The 5-year prostate-specific antigen relapse-free survival for <sup>125sup>I and <sup>103sup>Pd patients was 95.2%and 98.2%(p = 0.73), respectively.
ss="h4">Conclusion
There were no differences in acute or long-term genitourinary or gastrointestinal toxicity between <sup>125sup>I and <sup>103sup>Pd in combined modality therapy for prostate cancer. There may be less erectile toxicity with the use of <sup>103sup>Pd; however, additional followup of these patients is needed. There was no significant difference in 5-year prostate-specific antigen relapse-free survival between <sup>103sup>Pd and <sup>125sup>I.