After low and high dose-rate interstitial brachytherapy followed by IMRT radiotherapy for intermediate and high risk prostate cancer

BMC Cancer

Research Article

Minako Sumi¹  Akihisa Wakita²  Rei Umezawa²  Kazuma Kobayashi²  Koji Inaba²  Satoshi Nakamura²  Jun Itami²  Hiroyuki Okamoto²  Yoshinori Ito²  Naoya Murakami²  Kana Takahashi²  Hiroshi Igaki²  Madoka Morota³ 

[1] Department of Radiation Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, 135-0063, Tokyo, Japan;Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tsukiji 5-1-1, 104-0045, Tokyo, Japan;Department of Radiation Oncology, Showa University Koto Toyosu Hospital, 5-1-38 Toyosu, Koto-ku, 135-8577, Tokyo, Japan;

关键词: Clinically localized prostate cancer;    Low-dose-rate brachytherapy;    High-dose-rate brachytherapy;    International Prostate Symptom Score (IPSS);    Intensity-modulated radiation therapy (IMRT);   

DOI  :  10.1186/s12885-016-2329-7

 received in 2015-07-03, accepted in 2016-04-27,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe study aimed to compare urinary symptoms in patients with clinically localized prostate cancer after a combination of either low-dose-rate or high-dose-rate interstitial brachytherapy along with intensity-modulated radiation therapy (LDR-ISBT + IMRT or HDR-ISBT + IMRT).MethodsFrom June 2009 to April 2014, 16 and 22 patients were treated with LDR-ISBT + IMRT and HDR-ISBT + IMRT, respectively. No patient from these groups was excluded from this study. The prescribed dose of LDR-ISBT, HDR-ISBT, and IMRT was 115 Gy, 20 Gy in 2 fractions, and 46 Gy in 23 fractions, respectively. Obstructive and irritative urinary symptoms were assessed by the International Prostate Symptom Score (IPSS) examined before and after treatments. After ISBT, IPSS was evaluated in the 1st and 4th weeks, then every 2–3 months for the 1st year, and every 6 months thereafter.ResultsThe median follow-up of the patients treated with LDR-ISBT + IMRT and HDR-ISBT + IMRT was 1070.5 days and 1048.5 days, respectively (p = 0.321). The IPSS-increment in the LDR-ISBT + IMRT group was greater than that in the HDR-ISBT + IMRT between 91 and 180 days after ISBT (p = 0.015). In the LDR-ISBT + IMRT group, the IPSS took longer time to return to the initial level than in the HDR-ISBT + IMRT group (in LDR-ISBT + IMRT group, the recovery time was 90 days later). The dose to urethra showed a statistically significant association with the IPSS-increment in the irritative urinary symptoms (p = 0.011). Clinical outcomes were comparable between both the groups.ConclusionsBoth therapeutic modalities are safe and well suited for patients with clinically localized prostate cancer; however, it took patients longer to recover from LDR-ISBT + IMRT than from HDR-ISBT + IMRT. It is possible that fast dose delivery induced early symptoms and early recovery, while gradual dose delivery induced late symptoms and late recovery. Urethral dose reductions were associated with small increments in IPSS.

【 授权许可】

CC BY   
© Nakamura et al. 2016