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Title: A Comparison of Acute and Chronic Toxicity for Men With Low-Risk Prostate Cancer Treated With Intensity-Modulated Radiation Therapy or {sup 125}I Permanent Implant

Abstract

Purpose: To compare the toxicity and biochemical outcomes of intensity-modulated radiation therapy (IMRT) and {sup 125}I transperineal permanent prostate seed implant ({sup 125}I) for patients with low-risk prostate cancer. Methods and Materials: Between 1998 and 2004, a total of 374 low-risk patients (prostate-specific antigen < 10 ng/ml, T1c-T2b, Gleason score of 6 or less, and no neoadjuvant hormones) were treated at Fox Chase Cancer Center (216 IMRT and 158 {sup 125}I patients). Median follow-up was 43 months for IMRT and 48 months for {sup 125}I. The IMRT prescription dose ranged from 74-78 Gy, and {sup 125}I prescription was 145 Gy. Acute and late gastrointestinal (GI) and genitourinary (GU) toxicity was recorded by using a modified Radiation Therapy Oncology Group scale. Freedom from biochemical failure was defined by using the Phoenix definition (prostate-specific antigen nadir + 2.0 ng/ml). Results: Patients treated by using IMRT were more likely to be older and have a higher baseline American Urological Association symptom index score, history of previous transurethral resection of the prostate, and larger prostate volumes. On multivariate analysis, IMRT was an independent predictor of lower acute and late Grade 2 or higher GU toxicity and late Grade 2 or higher GI toxicity. Three-yearmore » actuarial estimates of late Grade 2 or higher toxicity were 2.4% for GI and 3.5% for GU by using IMRT compared with 7.7% for GI and 19.2% for GU for {sup 125}I, respectively. Four-year actuarial estimates of freedom from biochemical failure were 99.5% for IMRT and 93.5% for {sup 125}I (p = 0.09). Conclusions: The IMRT and {sup 125}I produce similar outcomes, although IMRT appears to have less acute and late toxicity.« less

Authors:
 [1];  [2]; ; ;  [1];  [3];  [1]
  1. Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States)
  2. Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, PA (United States)
  3. Department of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States)
Publication Date:
OSTI Identifier:
21124260
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 71; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2007.10.019; PII: S0360-3016(07)04436-7; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANTIGENS; BRACHYTHERAPY; CARCINOMAS; FAILURES; IODINE 125; PATIENTS; PROSTATE; RADIATION DOSES; RADIATION SOURCE IMPLANTS; RADIOPHARMACEUTICALS; TOXICITY

Citation Formats

Eade, Thomas N, Horwitz, Eric M., Ruth, Karen, Buyyounouski, Mark K, D'Ambrosio, David J, Feigenberg, Steven J, Chen, David Y.T., and Pollack, Alan. A Comparison of Acute and Chronic Toxicity for Men With Low-Risk Prostate Cancer Treated With Intensity-Modulated Radiation Therapy or {sup 125}I Permanent Implant. United States: N. p., 2008. Web. doi:10.1016/j.ijrobp.2007.10.019.
Eade, Thomas N, Horwitz, Eric M., Ruth, Karen, Buyyounouski, Mark K, D'Ambrosio, David J, Feigenberg, Steven J, Chen, David Y.T., & Pollack, Alan. A Comparison of Acute and Chronic Toxicity for Men With Low-Risk Prostate Cancer Treated With Intensity-Modulated Radiation Therapy or {sup 125}I Permanent Implant. United States. https://doi.org/10.1016/j.ijrobp.2007.10.019
Eade, Thomas N, Horwitz, Eric M., Ruth, Karen, Buyyounouski, Mark K, D'Ambrosio, David J, Feigenberg, Steven J, Chen, David Y.T., and Pollack, Alan. 2008. "A Comparison of Acute and Chronic Toxicity for Men With Low-Risk Prostate Cancer Treated With Intensity-Modulated Radiation Therapy or {sup 125}I Permanent Implant". United States. https://doi.org/10.1016/j.ijrobp.2007.10.019.
@article{osti_21124260,
title = {A Comparison of Acute and Chronic Toxicity for Men With Low-Risk Prostate Cancer Treated With Intensity-Modulated Radiation Therapy or {sup 125}I Permanent Implant},
author = {Eade, Thomas N and Horwitz, Eric M. and Ruth, Karen and Buyyounouski, Mark K and D'Ambrosio, David J and Feigenberg, Steven J and Chen, David Y.T. and Pollack, Alan},
abstractNote = {Purpose: To compare the toxicity and biochemical outcomes of intensity-modulated radiation therapy (IMRT) and {sup 125}I transperineal permanent prostate seed implant ({sup 125}I) for patients with low-risk prostate cancer. Methods and Materials: Between 1998 and 2004, a total of 374 low-risk patients (prostate-specific antigen < 10 ng/ml, T1c-T2b, Gleason score of 6 or less, and no neoadjuvant hormones) were treated at Fox Chase Cancer Center (216 IMRT and 158 {sup 125}I patients). Median follow-up was 43 months for IMRT and 48 months for {sup 125}I. The IMRT prescription dose ranged from 74-78 Gy, and {sup 125}I prescription was 145 Gy. Acute and late gastrointestinal (GI) and genitourinary (GU) toxicity was recorded by using a modified Radiation Therapy Oncology Group scale. Freedom from biochemical failure was defined by using the Phoenix definition (prostate-specific antigen nadir + 2.0 ng/ml). Results: Patients treated by using IMRT were more likely to be older and have a higher baseline American Urological Association symptom index score, history of previous transurethral resection of the prostate, and larger prostate volumes. On multivariate analysis, IMRT was an independent predictor of lower acute and late Grade 2 or higher GU toxicity and late Grade 2 or higher GI toxicity. Three-year actuarial estimates of late Grade 2 or higher toxicity were 2.4% for GI and 3.5% for GU by using IMRT compared with 7.7% for GI and 19.2% for GU for {sup 125}I, respectively. Four-year actuarial estimates of freedom from biochemical failure were 99.5% for IMRT and 93.5% for {sup 125}I (p = 0.09). Conclusions: The IMRT and {sup 125}I produce similar outcomes, although IMRT appears to have less acute and late toxicity.},
doi = {10.1016/j.ijrobp.2007.10.019},
url = {https://www.osti.gov/biblio/21124260}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 2,
volume = 71,
place = {United States},
year = {Sun Jun 01 00:00:00 EDT 2008},
month = {Sun Jun 01 00:00:00 EDT 2008}
}