Acute urinary toxicity following transperineal prostate brachytherapy using a modified Quimby loading method
| Autor: | Shiva K. Das, Rachel H. Chou, Robert W. Clough, Song K. Kang, B. Steffey, Su Min Zhou, Gustavo S. Montana, Richard K. Dodge, Mitchell S. Anscher, Gray Bowen, Niall J. Buckley, Ignacio Sarmina, Hi Sung L. Kang, Arthur W. Whitehurst, Sally S. Ingram, Jay H. Kim, Raymond E. Joyner |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Urinary system medicine.medical_treatment Brachytherapy Urology Adenocarcinoma Iodine Radioisotopes Prostate cancer Prostate medicine Humans Radiology Nuclear Medicine and imaging Aged Radioisotopes Analysis of Variance Radiation business.industry Prostatic Neoplasms Middle Aged Prostate-Specific Antigen medicine.disease Urination Disorders Surgery Radiation therapy Prostate-specific antigen medicine.anatomical_structure Logistic Models Oncology Toxicity Acute Disease business Prostate brachytherapy Palladium Follow-Up Studies |
| Zdroj: | International journal of radiation oncology, biology, physics. 50(4) |
| ISSN: | 0360-3016 |
| Popis: | To examine the acute urinary toxicity following transperineal prostate implant using a modified Quimby loading method with regard to time course, severity, and factors that may be associated with a higher incidence of morbidity.One hundred thirty-nine patients with prostate adenocarcinoma treated with brachytherapy from 1997 through 1999 had follow-up records available for review. Patients considered for definitive brachytherapy alone included those with prostate specific antigen (PSA)or = 6, Gleason score (GS)or = 6, clinical stageT2b, and prostate volumes generally less than 40 cc. Patients with larger prostate volumes were given neoadjuvant antiandrogen therapy. Those with GS6, PSA6, or StageT2a were treated with external beam radiation therapy followed by brachytherapy boost. Sources were loaded according to a modified Quimby method. At each follow-up, toxicity was graded based on a modified RTOG urinary toxicity scale.Acute urinary toxicity occurred in 88%. Grade I toxicity was reported in 23%, grade II in 45%, and grade III in 20%, with 14% requiring prolonged (greater than 1 week) intermittent or indwelling catheterization. Overall median duration of symptoms was 12 months. There was no difference in duration of symptoms between patients treated with I-125 or Pd-103 sources (p = 0.71). After adjusting for GS and PSA, multivariate logistic regression analysis showed higher incidence of grade 3 toxicity in patients with larger prostate volumes (p = 0.002), and those with more seeds implanted (p0.001). Higher incidence of prolonged catheterization was found in patients receiving brachytherapy alone (p = 0.01), with larger prostate volumes (p = 0.01), and those with more seeds implanted (p0.001).Interstitial brachytherapy for prostate cancer leads to a high incidence of acute urinary toxicity, most of which is mild to moderate in severity. A prolonged need for catheterization can occur in some patients. Patients receiving brachytherapy alone, those with prostate volumes greater than 30 cc, and those implanted with a greater number of seeds have the highest incidence of significant toxicity. |
| Databáze: | OpenAIRE |
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