Rectal morbidity after permanent prostate brachytherapy with dose escalation to biologic target volumes identified by SPECT/CT fusion
| Autor: | Edward Kim, Christopher C. Whalen, Rodney J. Ellis, D. Bruce Sodee, Pingfu Fu, John P. Spirnak, Martin I. Resnick, Deborah A. Kaminsky, Hang Zhou, Valdir C. Colussi |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Brachytherapy Rectum Adenocarcinoma Iodine Radioisotopes Prostate cancer Prostate medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Radiation Injuries Radiometry Prospective cohort study Aged Neoplasm Staging Aged 80 and over Tomography Emission-Computed Single-Photon Analysis of Variance business.industry Prostatic Neoplasms Radiotherapy Dosage Middle Aged medicine.disease Tumor Burden Radiation therapy Logistic Models Treatment Outcome medicine.anatomical_structure Oncology Toxicity Radiology Gastrointestinal Motility Tomography X-Ray Computed Nuclear medicine business Palladium Prostate brachytherapy Follow-Up Studies |
| Zdroj: | Brachytherapy. 6:149-156 |
| ISSN: | 1538-4721 |
| Popis: | Purpose To evaluate rectal morbidity after dose escalation to biologic target volumes identified by capromab pendetide (ProstaScint) single-photon emission tomography images coregistered with computed tomography (SPECT/CT). Methods and materials Two hundred thirty-nine consecutive patients diagnosed with T1c–T3b NxM0 adenocarcinoma of the prostate were treated with brachytherapy seed implant (SI) dose escalation to SPECT/CT–identified biologic target volumes, from February 1997 through December 2002. Patients received SI (n = 150) or external beam radiation therapy plus SI (n = 89). Rectal morbidity was evaluated by clinician scoring using the modified Radiation Therapy Oncology Group criteria. The median followup was 47.2 (range 24.8–96.1) months. Results The rate of acute Grades I and II toxicity was 29.9% and 3.7%, respectively, and chronic Grade I toxicity was 15.4%, 12.4%, 2.3%, and 1.8% at 1, 2, 3, and 4 years postimplant, respectively. Chronic Grade II toxicities were 1.8%, 1.9%, 1.5%, and 0.9% at 1, 2, 3, and 4 years, respectively. No Grade III rectal toxicity was reported. Chronic Grade IV rectal toxicity was 0.5% and 0.6% at 1.5 and 2.5 years, respectively. Ninety-six percent of patients reported freedom from all rectal toxicity after 3 years. Conclusions Dose intensification to occult tumor targets without increasing rectal toxicity may be achieved using SPECT/CT ProstaScint. Additional research to define the role of molecular imaging in prostate cancer is warranted. |
| Databáze: | OpenAIRE |
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