High-dose-rate Brachytherapy Combined with External Beam Radiotherapy for Localized Prostate Cancer: Correlation Between Clinical and Dosimetric Parameters and Late Genitourinary Toxicity
CUA Online Library. Kariya S. 06/22/13; 31414; UP-35
Disclosure(s): The author has no conflict of interest to disclose with respect to this presentation.
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Abstract
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Introduction and Objectives: Several investigations have revealed that the alpha/beta ratio for prostate cancer is atypically low, and that hypofractionated radiotherapy or high-dose-rate brachytherapy (HDR-BT) regimens using appropriate radiation doses are expected to improve the local control rate for localized prostate cancer. However, the increase in the total biological effective dose (BED) may cause an increase in the severity and incidence of normal tissue complications. The purpose of this study was to investigate if the clinical and dosimetric factors affected the incidence of late genitourinary (GU) toxicity after HDR-BT combined with external beam radiotherapy (EBRT).
Methods: The records of 115 patients with localized prostate cancer treated by HDR-BT combined with EBRT between November 2004 and December 2008 were analyzed. The fractionation schema for HDR-BT and EBRT was prospectively changed. The distribution of the fractionation schema used in the patients was as follows: 9 Gy x 2 + 2 Gy x 20 (BED3 = 139 Gy) in 57 patients (Group 1); and 9 Gy x 2 + 3 Gy x 13 (BED3 = 150 Gy) in 58 patients (Group 2). The median follow-up duration was 68 (range 48 – 97) months. The clinical and dosimetric factors affecting the incidence of late Grade 2 or worse GU toxicity were analyzed by univariate and multivariate analyses.
Results: Forty-two (36.5 %) and thirteen (11.3%) patients developed late Grade 2 and 3 GU toxicity, respectively. There were no statistically-significant differences between Group 1 and Group 2 in the incidence of late Grade 2 or 3 GU toxicity (42.1% and 53.4%, respectively, p = 0.1513). In the clinical factors, prior transurethral resection of the prostate (TURP) was the only factor related to late Grade 2 or 3 GU toxicity (p = 0.0046). None of the dosimetric factors were related.
Conclusions: Careful follow-up is needed for patients with a prior history of TURP who were treated with HDR-BT combined with EBRT.
Methods: The records of 115 patients with localized prostate cancer treated by HDR-BT combined with EBRT between November 2004 and December 2008 were analyzed. The fractionation schema for HDR-BT and EBRT was prospectively changed. The distribution of the fractionation schema used in the patients was as follows: 9 Gy x 2 + 2 Gy x 20 (BED3 = 139 Gy) in 57 patients (Group 1); and 9 Gy x 2 + 3 Gy x 13 (BED3 = 150 Gy) in 58 patients (Group 2). The median follow-up duration was 68 (range 48 – 97) months. The clinical and dosimetric factors affecting the incidence of late Grade 2 or worse GU toxicity were analyzed by univariate and multivariate analyses.
Results: Forty-two (36.5 %) and thirteen (11.3%) patients developed late Grade 2 and 3 GU toxicity, respectively. There were no statistically-significant differences between Group 1 and Group 2 in the incidence of late Grade 2 or 3 GU toxicity (42.1% and 53.4%, respectively, p = 0.1513). In the clinical factors, prior transurethral resection of the prostate (TURP) was the only factor related to late Grade 2 or 3 GU toxicity (p = 0.0046). None of the dosimetric factors were related.
Conclusions: Careful follow-up is needed for patients with a prior history of TURP who were treated with HDR-BT combined with EBRT.
Introduction and Objectives: Several investigations have revealed that the alpha/beta ratio for prostate cancer is atypically low, and that hypofractionated radiotherapy or high-dose-rate brachytherapy (HDR-BT) regimens using appropriate radiation doses are expected to improve the local control rate for localized prostate cancer. However, the increase in the total biological effective dose (BED) may cause an increase in the severity and incidence of normal tissue complications. The purpose of this study was to investigate if the clinical and dosimetric factors affected the incidence of late genitourinary (GU) toxicity after HDR-BT combined with external beam radiotherapy (EBRT).
Methods: The records of 115 patients with localized prostate cancer treated by HDR-BT combined with EBRT between November 2004 and December 2008 were analyzed. The fractionation schema for HDR-BT and EBRT was prospectively changed. The distribution of the fractionation schema used in the patients was as follows: 9 Gy x 2 + 2 Gy x 20 (BED3 = 139 Gy) in 57 patients (Group 1); and 9 Gy x 2 + 3 Gy x 13 (BED3 = 150 Gy) in 58 patients (Group 2). The median follow-up duration was 68 (range 48 – 97) months. The clinical and dosimetric factors affecting the incidence of late Grade 2 or worse GU toxicity were analyzed by univariate and multivariate analyses.
Results: Forty-two (36.5 %) and thirteen (11.3%) patients developed late Grade 2 and 3 GU toxicity, respectively. There were no statistically-significant differences between Group 1 and Group 2 in the incidence of late Grade 2 or 3 GU toxicity (42.1% and 53.4%, respectively, p = 0.1513). In the clinical factors, prior transurethral resection of the prostate (TURP) was the only factor related to late Grade 2 or 3 GU toxicity (p = 0.0046). None of the dosimetric factors were related.
Conclusions: Careful follow-up is needed for patients with a prior history of TURP who were treated with HDR-BT combined with EBRT.
Methods: The records of 115 patients with localized prostate cancer treated by HDR-BT combined with EBRT between November 2004 and December 2008 were analyzed. The fractionation schema for HDR-BT and EBRT was prospectively changed. The distribution of the fractionation schema used in the patients was as follows: 9 Gy x 2 + 2 Gy x 20 (BED3 = 139 Gy) in 57 patients (Group 1); and 9 Gy x 2 + 3 Gy x 13 (BED3 = 150 Gy) in 58 patients (Group 2). The median follow-up duration was 68 (range 48 – 97) months. The clinical and dosimetric factors affecting the incidence of late Grade 2 or worse GU toxicity were analyzed by univariate and multivariate analyses.
Results: Forty-two (36.5 %) and thirteen (11.3%) patients developed late Grade 2 and 3 GU toxicity, respectively. There were no statistically-significant differences between Group 1 and Group 2 in the incidence of late Grade 2 or 3 GU toxicity (42.1% and 53.4%, respectively, p = 0.1513). In the clinical factors, prior transurethral resection of the prostate (TURP) was the only factor related to late Grade 2 or 3 GU toxicity (p = 0.0046). None of the dosimetric factors were related.
Conclusions: Careful follow-up is needed for patients with a prior history of TURP who were treated with HDR-BT combined with EBRT.
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