High-dose-rate brachytherapy and hypofractionated external beam radiotherapy combined with long-term hormonal therapy for high-risk and very high-risk prostate cancer: outcomes after 5-year follow-up
| Autor: | Kazushige Hayakawa, Shouko Komori, Hiromichi Ishiyama, Masaomi Ikeda, Ken-ichi Tabata, Masashi Kitano, Akane Sekiguchi, Takefumi Satoh, Masatsugu Iwamura, Itaru Soda, Shogo Kawakami, Shinji Kurosaka, Masaki Kimura |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Oncology medicine.medical_specialty Health Toxicology and Mutagenesis medicine.medical_treatment Brachytherapy androgen deprivation therapy Gonadotropin-Releasing Hormone Androgen deprivation therapy Prostate cancer high-risk Risk Factors Internal medicine Prevalence medicine Humans Radiology Nuclear Medicine and imaging External beam radiotherapy Aged Aged 80 and over Radiation business.industry Prostatic Neoplasms Cancer Androgen Antagonists Radiotherapy Dosage Chemoradiotherapy very high-risk Middle Aged prostate cancer medicine.disease High-Dose Rate Brachytherapy Survival Rate Radiation therapy Treatment Outcome high-dose-rate brachytherapy Hormonal therapy Dose Fractionation Radiation Radiology Radiotherapy Conformal business Follow-Up Studies |
| Zdroj: | Journal of Radiation Research |
| ISSN: | 1349-9157 0449-3060 |
| DOI: | 10.1093/jrr/rrt128 |
| Popis: | The purpose of this study was to report the outcomes of high-dose-rate (HDR) brachytherapy and hypofractionated external beam radiotherapy (EBRT) combined with long-term androgen deprivation therapy (ADT) for National Comprehensive Cancer Network (NCCN) criteria-defined high-risk (HR) and very high-risk (VHR) prostate cancer. Data from 178 HR (n = 96, 54%) and VHR (n = 82, 46%) prostate cancer patients who underwent (192)Ir-HDR brachytherapy and hypofractionated EBRT with long-term ADT between 2003 and 2008 were retrospectively analyzed. The mean dose to 90% of the planning target volume was 6.3 Gy/fraction of HDR brachytherapy. After five fractions of HDR treatment, EBRT with 10 fractions of 3 Gy was administered. All patients initially underwent ≥ 6 months of neoadjuvant ADT, and adjuvant ADT was continued for 36 months after EBRT. The median follow-up was 61 months (range, 25-94 months) from the start of radiotherapy. The 5-year biochemical non-evidence of disease, freedom from clinical failure and overall survival rates were 90.6% (HR, 97.8%; VHR, 81.9%), 95.2% (HR, 97.7%; VHR, 92.1%), and 96.9% (HR, 100%; VHR, 93.3%), respectively. The highest Radiation Therapy Oncology Group-defined late genitourinary toxicities were Grade 2 in 7.3% of patients and Grade 3 in 9.6%. The highest late gastrointestinal toxicities were Grade 2 in 2.8% of patients and Grade 3 in 0%. Although the 5-year outcome of this tri-modality approach seems favorable, further follow-up is necessary to validate clinical and survival advantages of this intensive approach compared with the standard EBRT approach. |
| Databáze: | OpenAIRE |
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