Impact of real-time, dose-escalated permanent seed implant brachytherapy in intermediate-risk prostate cancer.
Rep Pract Oncol Radiother
; 25(4): 463-469, 2020.
Article
em En
| MEDLINE
| ID: mdl-32494221
ABSTRACT
PURPOSE:
To retrospectively evaluate biochemical control and toxicity in patients who underwent 125I seed brachytherapy (BT) for intermediate-risk prostate cancer (PCa). MATERIALS ANDMETHODS:
Between January 2004-December 2014, 395 patients with intermediate-risk PCa underwent 125I BT. Of these, 117 underwent preoperative planning (PP; 145â¯Gy) and 278 real-time intraoperative preplanning (IoP; 160â¯Gy). All patients were followed for ≥ 6 months (> 5 years in 48% of patients and > 7 years in 13%). Median follow-up was 59 months.RESULTS:
Biochemical relapse-free survival (BRFS) rates at 5 and 8 years were, respectively, 91.7% and 82.1%. By treatment group, the corresponding BRFS rates were 93.5% and 90% for IoP and 89% and 76.8% for PP. The maximum dose to the urethra remained unchanged (217â¯Gy) despite the dose escalation (from 145 to 160â¯Gy), without any significant increase in treatment-related toxicity (pâ¯=â¯0.13). Overall toxicity outcomes in the series were excellent, with only 3 cases (0.76%) of grade 3 genitourinary toxicity.CONCLUSION:
The real-time intraoperative planning technique at 160â¯Gy yields better biochemical controls than the preoperative planning technique at 145â¯Gy. Dose escalation did not increase urinary toxicity. The excellent results obtained with the IoP BT technique support its use as the first treatment option in this patient population.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article