Phase II trial of radiation dose escalation with conformal external beam radiotherapy and high-dose-rate brachytherapy combined with long-term androgen suppression in unfavorable prostate cancer: feasibility report
| Autor: | Pilar Romero, Mauricio Cambeiro, Raquel Ciérvide, Mercedes Teijeira, Carlos Galán, M. Moreno, José Javier Aristu, Jeanette Valero, Javier Zudaire, Rafael Martínez-Monge |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty medicine.medical_treatment Brachytherapy Urology Urogenital System Androgen suppression Gonadotropin-Releasing Hormone Prostate cancer medicine Humans Radiology Nuclear Medicine and imaging External beam radiotherapy Prospective Studies Aged Aged 80 and over Radiation business.industry Dose fractionation Cancer Prostatic Neoplasms Androgen Antagonists Middle Aged Prostate-Specific Antigen medicine.disease Combined Modality Therapy High-Dose Rate Brachytherapy Radiation therapy Gastrointestinal Tract Oncology Feasibility Studies Dose Fractionation Radiation Radiotherapy Conformal business Nuclear medicine |
| Zdroj: | International journal of radiation oncology, biology, physics. 76(2) |
| ISSN: | 1879-355X |
| Popis: | Purpose To determine the feasibility of combined long-term luteinizing hormone-releasing hormone agonist–based androgen suppressive therapy (AST) and dose escalation with high-dose-rate (HDR) brachytherapy for high-risk (HRPC) or very-high-risk prostate cancer (VHRPC). Methods and Materials Between January 2001 and October 2006, 134 patients (median age, 70 years) with either National Comprehensive Cancer Network criteria–defined HRPC ( n = 47, 35.1%) or VHRPC ( n = 87, 64.9%) were prospectively enrolled in this Phase II trial. Tumor characteristics included a median pretreatment prostate-specific antigen level of 14.6 ng/mL, a median clinical stage of T2c, and a median Gleason score of 7. Three-dimensional conformal radiotherapy (54 Gy in 30 fractions) was followed by HDR brachytherapy (19 Gy in 4 b.i.d. treatments). Androgen suppressive therapy started 0–3 months before three-dimensional conformal radiotherapy and continued for 2 years. Results One implant was repositioned with a new procedure (0.7%). Five patients (3.7%) discontinued AST at a median of 13 months (range, 6–18 months) because of disease progression ( n = 1), hot flashes ( n = 2), fatigue ( n = 1), and impotence ( n = 1). After a median follow-up of 37.4 months (range, 24–90 months), the highest Radiation Therapy Oncology Group–defined late urinary toxicities were Grade 0 in 47.8%, Grade 1 in 38.1%, Grade 2 in 7.5%, and Grade 3 in 6.7% of patients. Maximal late gastrointestinal toxicities were Grade 0 in 73.1%, Grade 1 in 16.4%, Grade 2 in 7.5%, and Grade 3 in 2.9% of patients. There were no Grade 4 or 5 events. Conclusions Intermediate-term results show that dose escalation with HDR brachytherapy combined with long-term AST is feasible and has a toxicity profile similar to that reported by previous HDR brachytherapy studies. |
| Databáze: | OpenAIRE |
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