Late toxicity and five year outcomes after high-dose-rate brachytherapy as a monotherapy for localized prostate cancer

Radiation Oncology

Daniel M Aebersold⁴  George N Thalmann³  Peter Manser⁴  Nikola Cihoric⁴  Bernhard Isaak⁴  Cyrill A Rentsch¹  Sebastian L Oesch⁴  Pirus Ghadjar² 

[1] Department of Urology, University of Basel, Spitalstrasse 21, Basel 4031, Switzerland;Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin 13353, Germany;Department of Urology, Bern University Hospital, Inselspital, Bern, Freiburgstrasse, Bern 3010, Switzerland;Department of Radiation Oncology with Division of Medical Radiation Physics, Bern University Hospital, Inselspital, Bern, Freiburgstrasse, Bern 3010, Switzerland

关键词: Brachytherapy;    Prostatic neoplasms;    Toxicity;    Radiotherapy;    Urogenital abnormalities;   

Others  :  802726
DOI  :  10.1186/1748-717X-9-122

 received in 2014-03-31, accepted in 2014-05-18,  发布年份 2014

【 摘 要 】

Background

To determine the 5-year outcome after high-dose-rate brachytherapy (HDR-BT) as a monotherapy.

Methods

Between 10/2003 and 06/2006, 36 patients with low (28) and intermediate (8) risk prostate cancer were treated by HDR-BT monotherapy. All patients received one implant and 4 fractions of 9.5 Gy within 48 hours for a total prescribed dose (PD) of 38 Gy. Five patients received concomitant androgen deprivation therapy (ADT). Toxicity was scored according to the common terminology criteria for adverse events from the National Cancer Institute (CTCAE) version 3.0. Biochemical recurrence was defined according to the Phoenix criteria and analyzed using the Kaplan Meier method. Predictors for late grade 3 GU toxicity were analyzed using univariate and multivariate Cox regression analyses.

Results

The median follow-up was 6.9 years (range, 1.5-8.0 years). Late grade 2 and 3 genitourinary (GU) toxicity was observed in 10 (28%) and 7 (19%) patients, respectively. The actuarial proportion of patients with late grade 3 GU toxicity at 5 years was 17.7%. Late grade 2 and 3 gastrointestinal (GI) toxicities were not observed. The crude erectile function preservation rate in patients without ADT was 75%. The 5 year biochemical recurrence-free survival (bRFS) rate was 97%. Late grade 3 GU toxicity was associated with the urethral volume (p = 0.001) and the urethral V₁₂₀ (urethral volume receiving ≥120% of the PD; p = 0.0005) after multivariate Cox regression.

Conclusions

After HDR-BT monotherapy late grade 3 GU was observed relatively frequently and was associated with the urethral V₁₂₀. GI toxicity was negligible, the erectile function preservation rate and the bRFS rate was excellent.

【 授权许可】

   
2014 Ghadjar et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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