Long-Term Results of an RTOG Phase II Trial (00-19) of External-Beam Radiation Therapy Combined With Permanent Source Brachytherapy for Intermediate-Risk Clinically Localized Adenocarcinoma of the Prostate
| Autor: | G. Morton, Madhava Baikadi, W. Robert Lee, Juanita Crook, Colleen A. Lawton, Michael Kuettel, Howard M. Sandler, Y. Yan, Michael Gillin, Selim Firat |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Organs at Risk Risk Cancer Research medicine.medical_specialty medicine.medical_treatment Brachytherapy Urogenital System Adenocarcinoma Iodine Radioisotopes Prostate cancer Erectile Dysfunction medicine Humans Dysuria Proctitis Radiology Nuclear Medicine and imaging Radiation Injuries Aged Aged 80 and over Radiation Radiotherapy Genitourinary system business.industry Prostatic Neoplasms Cancer Middle Aged Prostate-Specific Antigen Urination Disorders medicine.disease Gastrointestinal Tract Radiation therapy Oncology Dose Fractionation Radiation Radiology Neoplasm Grading medicine.symptom business Nuclear medicine Follow-Up Studies |
| Zdroj: | International Journal of Radiation Oncology*Biology*Physics. 82:e795-e801 |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2011.11.040 |
| Popis: | Purpose External-beam radiation therapy combined with low—doserate permanent brachytherapy are commonly used to treat men with localized prostate cancer. This Phase II trial was performed to document late gastrointestinal or genitourinary toxicity as well as biochemical control for this treatment in a multi-institutional cooperative group setting. This report defines the long-term results of this trial. Methods and Materials All eligible patients received external-beam radiation (45 Gy in 25 fractions) followed 2–6 weeks later by a permanent iodine 125 implant of 108 Gy. Late toxicity was defined by the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer late radiation morbidity scoring scheme. Biochemical control was defined by the American Society for Therapeutic Radiology and Oncology (ASTRO) Consensus definition and the ASTRO Phoenix definition. Results One hundred thirty-eight patients were enrolled from 20 institutions, and 131 were eligible. Median follow-up (living patients) was 8.2 years (range, 2.7–9.3 years). The 8-year estimate of late grade >3 genitourinary and/or gastrointestinal toxicity was 15%. The most common grade >3 toxicities were urinary frequency, dysuria, and proctitis. There were two grade 4 toxicities, both bladder necrosis, and no grade 5 toxicities. In addition, 42% of patients complained of grade 3 impotence (no erections) at 8 years. The 8-year estimate of biochemical failure was 18% and 21% by the Phoenix and ASTRO consensus definitions, respectively. Conclusion Biochemical control for this treatment seems durable with 8 years of follow-up and is similar to high—dose external beam radiation alone or brachytherapy alone. Late toxicity in this multi-institutional trial is higher than reports from similar cohorts of patients treated with high—dose external-beam radiation alone or permanent low—doserate brachytherapy alone, perhaps suggesting further attention to strategies that limit doses to normal structures or to unimodal radiotherapy techniques. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|