High-Dose-Rate Interstitial Brachytherapy as Monotherapy for Clinically Localized Prostate Cancer: Treatment Evolution and Mature Results

Journal Article · Fri Mar 01 04:00:00 EST 2013 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2012.07.004· OSTI ID:22224364

Zamboglou, Nikolaos ^[1]; Tselis, Nikolaos ^[1]; Baltas, Dimos ^[2]; Buhleier, Thomas ^[1]; Martin, Thomas ^[3]; Milickovic, Natasa; Papaioannou, Sokratis ^[2]; Ackermann, Hanns ^[4]; Tunn, Ulf W. ^[5]

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1. Department of Radiation Oncology, Klinikum Offenbach, Offenbach (Germany)
2. Department of Medical Physics and Engineering, Klinikum Offenbach, Offenbach (Germany)
3. Department of Radiation Oncology, Klinikum Bremen-Mitte, Bremen (Germany)
4. Institute of Biostatistics, J.W. Goethe University of Frankfurt, Frankfurt (Germany)
5. Department of Urology, Klinikum Offenbach, Offenbach (Germany)

Purpose: To report the clinical outcome of high-dose-rate (HDR) interstitial (IRT) brachytherapy (BRT) as sole treatment (monotherapy) for clinically localized prostate cancer. Methods and Materials: Between January 2002 and December 2009, 718 consecutive patients with clinically localized prostate cancer were treated with transrectal ultrasound (TRUS)-guided HDR monotherapy. Three treatment protocols were applied; 141 patients received 38.0 Gy using one implant in 4 fractions of 9.5 Gy with computed tomography-based treatment planning; 351 patients received 38.0 Gy in 4 fractions of 9.5 Gy, using 2 implants (2 weeks apart) and intraoperative TRUS real-time treatment planning; and 226 patients received 34.5 Gy, using 3 single-fraction implants of 11.5 Gy (3 weeks apart) and intraoperative TRUS real-time treatment planning. Biochemical failure was defined according to the Phoenix consensus, and toxicity was evaluated using Common Toxicity Criteria for Adverse Events version 3. Results: The median follow-up time was 52.8 months. The 36-, 60-, and 96-month biochemical control and metastasis-free survival rates for the entire cohort were 97%, 94%, and 90% and 99%, 98%, and 97%, respectively. Toxicity was scored per event, with 5.4% acute grade 3 genitourinary and 0.2% acute grade 3 gastrointestinal toxicity. Late grade 3 genitourinary and gastrointestinal toxicities were 3.5% and 1.6%, respectively. Two patients developed grade 4 incontinence. No other instance of grade 4 or greater acute or late toxicity was reported. Conclusion: Our results confirm IRT-HDR-BRT is safe and effective as monotherapy for clinically localized prostate cancer.

• OSTI ID: 22224364
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 85; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRACHYTHERAPY
COMPUTERIZED TOMOGRAPHY
DOSE RATES
MATERIALS
NEOPLASMS
PATIENTS
PLANNING
PROSTATE
RADIATION SOURCE IMPLANTS
TOXICITY