Permanent interstitial low-dose-rate brachytherapy for prostate cancer: institutional experience with implementation and predictive factors for outcome and side effects

IF 0.3 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Radiotherapy in Practice Pub Date : 2023-06-22 DOI:10.1017/S1460396923000213

Felix Fels, E. Okonkwo, J. G. Grossmann, Thomas H Schadt, S. Laschke, G. Lövey, Dieter Lansing, U. Freund, Reiner Steurer, F. Momm

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引用次数: 0

Abstract

Abstract Introduction: Low-dose-rate brachytherapy (LDR brachytherapy) with Iodine-125-seeds is an established treatment modality for low- and favourable intermediate-risk prostate cancer. Our single institution experience in this field was retrospectively studied. Methods: Two-hundred sixty consecutive patient records were reviewed for demographic, disease, therapy and side effect data. The patients were divided into subgroups by pre- and post-implant prostate-specific antigen (PSA) levels and by different LDR brachytherapy techniques used, that is, preoperative planning technique (PPT) versus intraoperative real-time planning (IOR). Data were analysed by Kaplan–Meier method and appropriate testing was conducted for PSA biochemical recurrence (BCR) and for toxicities. Results: After median follow-up of 65·0 months, 94·0% of all patients were free from BCR. This endpoint showed no significant differences by patient age, initial PSA, PSA decrease over time, Gleason score and implanted total activity. Patients with IOR were free of BCR in 98·9% (180/182) versus 76·9% (40/52) with PPT. All patients with a PSA nadir of <0·1 ng/mL were free from BCR. Six patients (2·5%) reported an incontinence grade 1. Transient nocturia/urge and dysuria appeared in 54·7% and 22·6% of patients. Conclusions: Consistent with literature, LDR brachytherapy for low- and intermediate-risk prostate cancer appeared highly effective for freedom from BCR with mild side effects.

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前列腺癌症的永久性间质低剂量率近距离放射治疗：实施的机构经验以及结果和副作用的预测因素

摘要简介：碘-125针低剂量率近距离放射治疗（LDR近距离放射疗法）是一种已建立的治疗癌症中盘前列腺癌的方法。我们对这一领域的单一机构经验进行了回顾性研究。方法：对260例连续患者的人口统计学、疾病、治疗和副作用数据进行回顾。根据植入前和植入后前列腺特异性抗原（PSA）水平以及使用的不同LDR近距离放射治疗技术，即术前计划技术（PPT）和术中实时计划技术（IOR），将患者分为亚组。通过Kaplan–Meier方法分析数据，并对PSA生化复发（BCR）和毒性进行适当的测试。结果：中位随访65.0个月后，94.0%的患者无BCR。该终点在患者年龄、初始PSA、PSA随时间降低、Gleason评分和植入总活性方面没有显著差异。IOR患者无BCR的比例为98.9%（180/182），而PPT患者为76.9%（40/52）。所有PSA最低点＜0.1 ng/mL的患者均无BCR。6名患者（2.5%）报告失禁等级为1级。54.7%和22.6%的患者出现短暂性夜尿/尿急和排尿困难。结论：与文献一致的是，LDR近距离治疗癌症低、中盘前列腺癌对BCR的自由度非常有效，副作用轻微。

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来源期刊

Journal of Radiotherapy in Practice RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

0.80

自引率

0.00%

发文量

期刊介绍： Journal of Radiotherapy in Practice is a peer-reviewed journal covering all of the current modalities specific to clinical oncology and radiotherapy. The journal aims to publish research from a wide range of styles and encourage debate and the exchange of information and opinion from within the field of radiotherapy practice and clinical oncology. The journal also aims to encourage technical evaluations and case studies as well as equipment reviews that will be of interest to an international radiotherapy audience.