scholarly journals Comparison of EBRT and I-125 seed brachytherapy concerning outcome in intermediate-risk prostate cancer

2021 ◽  
Author(s):  
Matthias Moll ◽  
Andreas Renner ◽  
Christian Kirisits ◽  
Christopher Paschen ◽  
Alexandru Zaharie ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Side Effects ◽  
Cancer Patients ◽  
External Beam Radiotherapy ◽  
External Beam ◽  
Intermediate Risk ◽  
Risk Prostate Cancer ◽  
Gastrointestinal Side Effects ◽  
Over Time

Abstract Purpose This study’s objective was the comparison of external beam radiotherapy (EBRT) and I‑125 seed brachytherapy regarding clinical outcome and development of side effects. Patients and methods In all, 462 localized intermediate-risk prostate cancer patients treated between 2000 and 2019 at our department using either I‑125 seed brachytherapy or EBRT with a dose of 74 or 78 Gy were included: 297 patients were treated with EBRT and 165 with seeds. Biochemical no evidence of disease (bNED) rates according to Phoenix definition as well as late gastrointestinal and urogenital side effects (EORTC/RTOG) were assessed. Results Patients were followed up yearly with a median follow-up of 54 (3–192) months. Observed bNED rates for 74 Gy, 78 Gy and seeds were 87, 92, and 88% after 5 years and 71, 85, and 76% after 9 years, respectively. No significant differences were found comparing seeds with 74 Gy (p = 0.81) and 78 Gy (p = 0.19), as well as between 74 and 78 Gy (p = 0.32). Concerning gastrointestinal side effects, EBRT showed significantly higher rates of RTOG grade ≥ 2 toxicity compared to seeds, but at no point of the follow-up more than 10% of all patients. However, genitourinary side effects were significantly more prevalent in patients treated with seeds, with 33% RTOG grade ≥ 2 toxicity 12 months after treatment. Nevertheless, both types of side effects decreased over time. Conclusion Favorable intermediate-risk prostate cancer patients can be treated either by external beam radiotherapy (74/78 Gy) or permanent interstitial seed brachytherapy.

Comparison between external beam radiotherapy (70Gy/74Gy) and permanent interstitial brachytherapy in 890 intermediate risk prostate cancer patients

2012 ◽  
Vol 103 (2) ◽  
pp. 223-227 ◽  
Author(s):  
Gregor Goldner ◽  
Richard Pötter ◽  
Jan J. Battermann ◽  
Christian Kirisits ◽  
Maximilian P. Schmid ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
External Beam Radiotherapy ◽  
Interstitial Brachytherapy ◽  
External Beam ◽  
Intermediate Risk ◽  
Risk Prostate Cancer

Treating intermediate-risk prostate cancer with hypofractionated external beam radiotherapy alone.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 93-93
Author(s):  
A. Dal Pra ◽  
S. Faria ◽  
F. L. Cury ◽  
M. David ◽  
M. Duclos ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
External Beam Radiotherapy ◽  
Androgen Deprivation ◽  
Biochemical Failure ◽  
External Beam ◽  
Intermediate Risk ◽  
Conventional Fractionation ◽  
Gu Toxicity ◽  
Risk Prostate Cancer

93 Background: A wide range of therapeutic alternatives is available for the treatment of intermediate-risk prostate cancer (IRPC). The use of hypofractionated external beam radiotherapy (HypoRT) in this group of patients appears to be an attractive option. Non-randomized institutional results have provided similar outcomes to conventional fractionation. For health-systems such as we have in Canada, where many patients live far, it significantly shortens treatment duration and impacts favorably in health costs. We report our results using HypoRT alone in IRPC. Methods: Between October/2002 and July/2009, 82 men with IRPC (T2b-T2c, or PSA 10–20 ng/dL, or GS=7) were treated with HypoRT, without any androgen deprivation. Ultrasound image guidance was used daily to confirm setup. The dose was 66 Gy in 22 daily fractions of 3 Gy (BED=79.4Gy/44) prescribed at the isocenter. PTV was the prostate (+/− 1cm seminal vesicles) with 7-mm margin in all directions. GI and GU toxicity were prospectively assessed every 4–6 months using the CTCAE v3 scoring system. Biochemical failure was defined as nadir PSA + 2 ng/dL. Results: 60% of patients had Gleason score 7; 43% had stage T2; median initial PSA=9 ng/ml; median age 71 years. With a median follow-up of 43 months (range: 7–89), only three patients (4%) have developed biochemical failure. All three showed metastatic disease few months after biochemical failure. Actuarial biochemical recurrence free survival (bNED) is 95.4%. There was no death related to prostate cancer. Three patients died from other causes without biochemical failure. The 5-year overall survival was 93%. At the last follow up visit, grade ≥ 2 late GI and GU toxicity rates were 2% and 7%, respectively. No grade 4 or 5 has occurred. Conclusions: Men with IRPC treated with 66Gy/22 fractions and without androgen deprivation have experienced excellent 5-year biochemical control rate with acceptable late toxicity. This regimen is very convenient because the duration of the treatment is half of the time used with conventional fractionation. Whether the addition of short-term androgen deprivation would further improve outcome remains unclear. No significant financial relationships to disclose.

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