Single fraction high-dose-rate brachytherapy as monotherapy for low and intermediate risk prostate cancer: toxicities and early outcomes from a single institutional experience.

Autor: Barnes JM; Saint Louis University School of Medicine, Saint Louis, United States., Gabani P; Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, United States., Sanders M; University of Missouri-St. Louis, Saint Louis, United States., Chundury A; Department of Radiation Oncology, Rutgers Robert Wood Johnson Medical School, New Brunswick, United States., Altman M; Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, United States., Garcia-Ramirez J; Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, United States., Li H; Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, United States., Zoberi JE; Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, United States., Baumann BC; Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, United States., Gay HA; Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, United States.
Jazyk: angličtina
Zdroj: Journal of contemporary brachytherapy [J Contemp Brachytherapy] 2019 Oct; Vol. 11 (5), pp. 399-408. Date of Electronic Publication: 2019 Oct 30.
DOI: 10.5114/jcb.2019.89367
Abstrakt: Purpose: High-dose-rate brachytherapy (HDR-BT) delivered in a single fraction as monotherapy is a potential treatment modality for low- and intermediate-risk prostate cancer (LIR-PC); however, outcome data with this technique remain limited. Here we describe our institutional HDR monotherapy experience and report the efficacy and toxicity of this treatment.
Material and Methods: LIR-PC patients who received a definitive single fraction HDR-BT during 2013-2017 were retrospectively identified. The intended HDR monotherapy dose was 19 Gy in one fraction. Acute (< 90 days) and late (≥ 90 days) toxicity was assessed using CTCAE version 4.03. Trends in prostate-specific antigen (PSA) and American Urological Association (AUA) symptom scores after treatment were assessed using Bayesian linear mixed models. The Kaplan-Meier method was used to evaluate biochemical failure-free survival (BFFS).
Results: 28 patients with median follow-up of 23.6 months were identified. The median age at treatment was 65 years (48-83). The NCCN risk groups were low in 14, favorable intermediate in 10, and unfavorable intermediate in 4 patients. There were 5 (18%) and 0 (0%) acute grade 2 genitourinary (GU) and gastrointestinal (GI) toxicities, respectively, and one (4%) acute grade 3 GU toxicity. There were no late grade 3 toxicities, and 5 (18%) and 0 (0%) late grade 2 GU and GI toxicities respectively. PSA values and AUA symptom scores decreased significantly after treatment. There were 3 biochemical failures with the two- and three-year BFFS of 90.7% and 80.6%, respectively.
Conclusions: Early results from a single institution suggest that single fraction HDR-BT with 19 Gy has limited toxicity, although with suboptimal biochemical control.
Competing Interests: The authors report no conflict of interest.
(Copyright: © 2019 Termedia Sp. z o. o.)
Databáze: MEDLINE
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