eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
Current Issue Archive Supplements Articles in Press Journal Information Aims and Scope Editorial Office Editorial Board Register as Author Register as Reviewer Instructions for Authors Abstracting and indexing Subscription Advertising Information Links
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank

6/2020
vol. 12
 
Share:
Share:
abstract:
Original paper

Focal low-dose-rate prostate brachytherapy for low- and intermediate-risk prostate cancer

Hiroaki Kunogi
1
,
Yoshiaki Wakumoto
2
,
Terufumi Kawamoto
1
,
Masaki Oshima
1
,
Shigeo Horie
2
,
Keisuke Sasai
1

1.
Department of Radiation Oncology, Juntendo University, Tokyo, Japan
2.
Department of Urology, Juntendo University, Tokyo, Japan
J Contemp Brachytherapy 2020; 12, 6: 554–561
Online publish date: 2020/12/18
View full text Get citation
 
Purpose
To prospectively investigate the efficacy and feasibility of focal low-dose-rate (LDR) prostate brachytherapy for low- and intermediate-risk prostate cancer.

Material and methods
Between October 2014 and May 2019, nineteen low- and intermediate-risk prostate cancer patients who presented with abnormality on both diffusion-weighted and T2-weighted magnetic resonance imaging (MRI) underwent focal LDR brachytherapy at our institution. Focal gross tumor volume (F-GTV) was delineated on transrectal ultrasound, based on abnormality seen on fused T2-weighted MRI. F-GTV was expanded by 5 mm, as a safety margin, to create focal clinical target volume (F-CTV). Prescribed dose to F-CTV was 145 Gy. Biochemical recurrence (BCR) was determined using Phoenix criterion (prostate specific antigen nadir + 2 ng/ml). Pre- and post-implant dosimetry data were compared using non-parametric Wilcoxon’s rank sum test. Treatment-related toxicities were evaluated using common terminology criteria for adverse events.

Results
Mean F-CTV D90% was significantly lower in the post-implant evaluation than in intraoperative planning (p = 0.004). On post-implant dosimetry, the mean D90% for F-GTV and mean V100% for the entire prostate were 222 Gy and 35%, respectively. Median follow-up time for all patients was 31 months. BCR occurred in one patient after 23 months. Kaplan-Meier 2-year BCR-free rate was 92.9% (95% confidence interval [CI]: 79.4-100%). No patients had grade 1 or greater gastrointestinal toxicity. Three patients who were taking -blockers to treat benign prostatic hyperplasia (present before brachytherapy), experienced no treatment-related genitourinary toxicities. Two patients suffered from temporary grade 2 urinary frequency. None of the remaining patients experienced grade 2 or higher genitourinary toxicity.

Conclusions
Focal LDR prostate brachytherapy appears acceptable for MRI-based index tumors, with a low cumulative incidence of BCR. Such brachytherapy might offer a feasible minimally invasive therapeutic option for localized prostate cancer.

keywords:

focal therapy, LDR brachytherapy, prostate cancer

 
Quick links
© 2024 Termedia Sp. z o.o.
Developed by Bentus.