Urethral toxicity vs. cancer control—Lessons to be learned from high–dose rate brachytherapy combined with intensity-modulated radiation therapy in intermediate- and high-risk prostate cancer

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• 作者：Pirus Ghadjar¹ ; Cyrill A. Rentsch² ; Bernhard Isaak¹ ; Frank Behrensmeier¹ ; George N. Thalmann³ ; Daniel M. Aebersold¹ ; ^{daniel.aebersold@insel.ch"" rel=""nofollow}
• 关键词：Brachytherapy ; IMRT ; Prostate cancer ; Toxicity
• 刊名：Brachytherapy
• 出版年：2011
• 出版时间：July-August 2011
• 年：2011
• 卷：10
• 期：4
• 页码：286-294
• 全文大小：359 K

文摘

class=""h4"">Purpose

To describe biochemical relapse-free survival (BRFS) and late toxicity after combined high–dose rate brachytherapy (HDR-B) and intensity-modulated radiation therapy (IMRT) in intermediate- and high-risk prostate cancer patients.

class=""h4"">Methods and Materials

From March 2003 to September 2005, 64 men were treated by 3 × 7 Gy HDR-B using one implant followed by 50 Gy IMRT. Median age was 66.1 years; risk of recurrence was intermediate in 30 (47 % ) or high in 34 (53 % ) patients. Forty-four (69 % ) patients received hormonal therapy. Patients were treated with a median of 13 HDR-B applicators (range, 8–17). Biochemical relapse was defined according to Phoenix criteria. Toxicity was scored according to the Common Toxicity Criteria scale version 3.0.

class=""h4"">Results

Median followup was 5.1 years. The 3-year BRFS was 100 % and 91 % for intermediate- and high-risk patients. Late Grade 2 gastrointestinal (GI) toxicity occurred in 3 (4.7 % ) patients, late Grade 3 GI toxicity was absent. Late Grade 3 and 4 genitourinary (GU) toxicity was observed in 7 (10.9 % ) and 2 (3.1 % ) patients. The 5-year Grade 3 or higher late GU toxicity-free survival was associated with a higher number of HDR-B applicators (p = 0.049).

class=""h4"">Conclusions

The 3-year BRFS was excellent and late GI toxicity was negligible. However, the late Grade 3 and 4 GU toxicity was unacceptably high.