scholarly journals Brachytherapy is a Promising Treatment for Prostate Cancer

2017 ◽  
Vol 10 (1) ◽  
pp. 79-85 ◽  
Author(s):  
Dmitry Yurievich Kamenev ◽  
Ivan Petrovich Moshurov ◽  
Bronislava Borisovna Kravets ◽  
Nataliya Viktorovna Korotkikh
Keyword(s):  
Prostate Cancer ◽  
Dose Rate ◽  
High Dose Rate ◽  
High Dose ◽  
Free Survival ◽  
Pulmonary System ◽  
Choice Of Treatment ◽  
Promising Treatment ◽  
Contact Radiation ◽  
Methods Of Treatment

Abstract – prostate Cancer is one of the most common cancers among men. Incidence is second only to tumors of the broncho-  pulmonary system. In recent years significantly increased the interest in contact radiation methods of treatment of this disease (brachytherapy). In the treatment of prostate cancer there is experience of application of different source of dose-rate  used sources of low dose (isotopes of iodine (125I), palladium (103Pd) and cesium (131Cs) and sources used for high dose rate (iridium Ir192 or cobalt 60 Co). In Russia the greatest popularity is the use of isotope Ir192 andI125 for brachytherapy. Given indentichnost the indications for treatment, equivalent figures cancerspecifically and relapse-free survival, the question of the choice of treatment is very important. A brief review of the literature on the use of brachytherapy for prostate cancer sources of different dose. Presents comparative characteristics of treatment results, complications, early and late toxic reactions when used brachytherapy isotopes different dose.

scholarly journals Low and high-dose-rate brachytherapy in combination with external beam radiotherapy for high risk prostate cancer

2021 ◽  
Vol 17 (2) ◽  
pp. 72-82
Author(s):  
V. A. Solodkiy ◽  
A. Yu. Pavlov ◽  
A. D. Tsibulskii ◽  
G. A. Panshin ◽  
A. G. Dzidzaria ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Dose Rate ◽  
External Beam Radiotherapy ◽  
High Dose Rate ◽  
Biochemical Failure ◽  
High Dose ◽  
External Beam ◽  
Free Survival ◽  
Group 4

Background. Prostate cancer (PCa) in the Russian Federation takes the leading place in the prevalence of cancer among the male population.Objective: to investigate the effect of increasing a single focal dose in high-dose-rate brachytherapy (HDR-BT) in combination with external beam radiotherapy on biochemical failure-free survival and local control in patients with high-risk PCa. Materials and methods. The study included 350 men with PCa in the group of high and extremely high risk of progression. All patients included in the study were divided into 4 groups. Groups 1, 2 and 3 included 276 patients who received HDR-BT with a 192Ir source with a single dose per fraction: 10 Gy (n = 83), 12 Gy (n = 46) and 15 Gy (n = 147). Group 4 included 74 patients who received low-dose-rate brachytherapy with 125I sources up to a total focal dose of 110 Gy. At the 2 stage, external beam radiotherapy was a conventional fractionation (single dose of 2 Gy, total - 44-46 Gy).Results. Of 350 patients over a 5-year follow-up period, PCa recurrence was noted in 65 (18.6 %). The 3- and 5-year biochemical failure-free survival rates in the general cohort of patients were 87.4 and 81.4 %. 5-year biochemical failure-free survival was significantly higher in group 3 relative to group 4 and amounted to 89.8 and 74.2 % (p = 0.03). Increasing the dose for HDR-BT from 10 to 12 Gy per fraction significantly reduced the frequency of local relapses from 15.7 % (in group 1) to 2.2 % (in group 2) (p = 0.0001) while maintaining the level of genitourinary and gastrointestinal toxicity. Conclusion. The use of a combination of brachytherapy and external beam radiotherapy in patients with high risk PCa is highly effective in achieving local control of the tumor. The optimal fractionation regime for HDR-BT remains a matter of debate. The use of 15 Gy per fraction for HDR-BT in combination with external beam radiotherapy is the most optimal fractionation regimen in patients with high-risk PCa.

Interstitial high dose rate (HDR) brachytherapy alone for early stage prostate cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14633-14633
Author(s):  
R. J. Mark ◽  
P. J. Anderson ◽  
T. Neumann ◽  
M. Nair
Keyword(s):  
Prostate Cancer ◽  
Dose Rate ◽  
Gleason Score ◽  
Disease Free Survival ◽  
High Dose Rate ◽  
High Dose ◽  
Free Survival ◽  
Treatment Volume ◽  
Grade 3 ◽  
Disease Free

14633 Background: Transrectal Ultrasound (TRUS) guided interstitial implant for prostate cancer using Low Dose Rate (LDR) and High Dose Rate (HDR) technique has been reported with results comparing favorably to surgery and External Beam Radiation Therapy (EBRT). Often, HDR and LDR interstitial implant is combined with EBRT. There is little published data on HDR alone. We report our results with HDR alone. Methods: Between 1997 and 2006, 167 patients with T1 and T2 localized prostate underwent TRUS guided interstitial implant. There were no Gleason Score or PSA exclusions. No patient received EBRT or Hormonal Blockade. Median Gleason Score was 7 (range: 4 to 10). Median PSA was 9.3 (2.7 to 39.8). Treatment volumes ranged from 42 cm3 to 196 cm3. Treatment volume included the prostate and seminal vesicles in all cases. Our protocol for HDR alone, has called for two HDR Implants. The treatment volume received 2,250 cGy in 3 fractions prescribed to the 100% Isodose line, given over 24 hours. A 2nd implant was performed 4 weeks later, delivering a further 2,250 cGy in 3 fractions, bringing the final dose to the prostate to 4,500 cGy in 6 fractions. Urethral dose points (12–16) were followed, and limited to ≤ 105% of the prescription dose. Results: With a median follow-up of 64 months (range: 6 months to 112 months), PSA disease free survival was 89.8% (150/167). Urethral stricture requiring dilatation has developed in 4.2% (7/167) of patients. Urinary stress incontinence has occurred in 3.6% (6/167). RTOG late bladder toxicities were: 0% Grade 4, 0% Grade 3, and 3.6% (6/167) Grade 2. RTOG late rectal toxicities were: 0.6% (1/167) Grade 4, 0% Grade 3, 1.8% (3/167) Grade 2, and 2.4% (4/167) Grade 1. There have been no cases of rectal incontinence to date. Conclusions: Five year results with HDR implant alone compare favorably to EBRT, LDR ± EBRT, and HDR + EBRT, both with regard to PSA disease free survival, and complications. HDR offers other advantages over LDR, such as no radiation exposure to hospital personnel, no seed migration, greater dose flexibility and precision of radiation dose delivery. Larger volumes can be treated with HDR. By omitting EBRT, bladder and rectal complications appear to be significantly reduced. No significant financial relationships to disclose.

scholarly journals High-Dose-Rate Brachytherapy as Monotherapy for Low- and Intermediate-Risk Prostate Cancer. Oncological Outcomes After a Median 15-Year Follow-Up

2021 ◽  
Vol 11 ◽  
Author(s):  
Manuel Behmueller ◽  
Nikolaos Tselis ◽  
Nikolaos Zamboglou ◽  
Eleni Zoga ◽  
Dimos Baltas ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Dose Rate ◽  
High Dose Rate ◽  
High Dose ◽  
Intermediate Risk ◽  
Biochemical Relapse ◽  
Free Survival ◽  
Grade 3

IntroductionTo evaluate the oncological outcome of high dose rate (HDR) brachytherapy (BRT) as monotherapy for clinically localised prostate cancer (PCA).Material and MethodsBetween January 2002 and February 2004, 141 consecutive patients with clinically localised PCA were treated with HDR-BRT monotherapy. The cohort comprised 103 (73%) low-, 32 (22.7%) intermediate- and 6 (4.3%) high risk patients according to D’Amico classification or 104 (73.8%) low-, 24 (17.0%) intermediate favourable-, 12 (8.5%) intermediate unfavourable- and one (0.7%) very high risk patient according to National Comprehensive Cancer Network (NCCN) one. Patients received four fractions of 9.5 Gy delivered within a single implant up to a total physical dose of 38 Gy. Catheter-implantation was transrectal ultrasound-based whereas treatment planning CT-based. Thirty-three patients (23.4%) received ADT neoadjuvantly and continued concurrently with BRT. Biochemical relapse-free survival (BRFS) was defined according to the Phoenix Consensus Criteria and genitourinary (GU)/gastrointestinal (GI) toxicity evaluated using the Common Toxicity Criteria for Adverse Events version 5.0.ResultsMedian age at treatment and median follow-up time was 67.2 and 15.2 years, respectively. Twenty-three (16.3%) patients experienced a biochemical relapse and 5 (3.5%) developed distant metastases, with only one patient dying of PCA. The BRFS was 85.1% at 15 years and 78.7% at 18 years. The corresponding overall survival, metastases-free survival, and prostate cancer specific mortality at 15- and 18-years was 73.9%/59.1%, 98.3%/90.6%, and 100%/98.5% respectively. Late grade 3 GI and GU toxicity was 4.2% and 5.6% respectively. Erectile dysfunction grade 3 was reported by 27 (19%) patients. From the prognostic factors evaluated, tumor stage (≤T2b compared to ≥T2c) along with the risk group (low-intermediate vs. high) when using the D’Amico classification but not when the NCCN one was taken into account, correlated significantly with BRFS.ConclusionOur long-term results confirm HDR-BRT to be a safe and effective monotherapeutic treatment modality for low- and intermediate risk PCA.

scholarly journals Conventional dose versus dose escalated radiotherapy including high-dose-rate brachytherapy boost for patients with Gleason score 9–10 clinical localized prostate cancer

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Hideya Yamazaki ◽  
Gen Suzuki ◽  
Norihiro Aibe ◽  
Daisuke Shimizu ◽  
Takuya Kimoto ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Dose Rate ◽  
Gleason Score ◽  
External Beam Radiotherapy ◽  
High Dose Rate ◽  
High Dose ◽  
External Beam ◽  
Free Survival ◽  
Conventional Dose ◽  
Brachytherapy Boost

AbstractAs several recent researches focus on the importance of Gleason 9–10, we examine the role of radiotherapy dose escalation in those patients. We analyzed 476 patients with Gleason score 9–10 prostate cancer treated with radiotherapy. Of them, 127 patients were treated with conventional-dose external beam radiotherapy (Conv RT) and 349 patients were treated with high-dose radiotherapy (HDRT; 249 patients received high-dose-rate brachytherapy boost + external beam radiotherapy [HDR boost] and 100 patients received intensity-modulated radiotherapy [IMRT]). We compared these treatment groups using multi-institutional retrospective data. The patients had a median follow-up period of 66.3 months. HDRT showed superior biochemical disease-free survival (bDFS) rate (85.2%; HDR boost 84.7% and IMRT 86.6%) to Conv RT (71.1%, p < 0.0001) at 5 years, with a hazard ratio of 0.448. There were borderline difference in prostate cancer-specific mortality (PCSM; 4.3% and 2.75%, p = 0.0581), and distant metastasis-free survival (DMFS; 94.4% and 89.6%, p = 0.0916) rates at 5-years between Conv RT and HDRT group. Dose escalated radiotherapy showed better bDFS, borderline improvement in PCSM, and equivocal outcome in DMFS in with clinically localized Gleason 9–10 prostate cancer.

scholarly journals Salvage high dose rate brachytherapy for recurrent prostate cancer after definitive radiation

2021 ◽  
Author(s):  
Susan Y. Wu ◽  
Anthony C. Wong ◽  
Katsuto Shinohara ◽  
Mack Roach ◽  
J. Adam M. Cunha ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Dose Rate ◽  
High Dose Rate ◽  
High Dose ◽  
Recurrent Prostate Cancer ◽  
High Dose Rate Brachytherapy
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