The potential of low-dose-rate brachytherapy with iodine-1 25 in the treatment of local recurrences of prostate cancer after primary high-dose-rate monotherapy

被引:4
作者
Burchardt, Wojciech M. [1 ,2 ,5 ]
Chyrek, Artur J. [1 ,2 ]
Bieleda, Grzegorz M. [2 ,3 ]
Burchardt, Ewa [2 ,4 ]
Chichel, Adam [1 ]
机构
[1] Greater Poland Canc Ctr, Brachytherapy Dept, Poznan, Poland
[2] Poznan Univ Med Sci, Electroradiol Dept, Poznan, Poland
[3] Greater Poland Canc Ctr, Med Phys Dept, Poznan, Poland
[4] Greater Poland Canc Ctr, Dept Radiotherapy & Oncol Gynecol, Poznan, Poland
[5] Poland Canc Ctr, Brachytherapy Dept, Garbary 15, PL-61866 Poznan, Poland
关键词
salvage brachytherapy; recurrence prostate cancer; LDR brachytherapy; SALVAGE BRACHYTHERAPY; RADIATION-THERAPY; RADIOTHERAPY; ALPHA/BETA; MECHANISMS; RELAPSE; I-125; MEN;
D O I
10.5114/jcb.2023.126618
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: The incidence of local prostate cancer recurrences after monotherapy with high-dose-rate brachytherapy (HDR-BT) is low. However, a cumulated number of local recurrences during follow-up is naturally observed in highly specialized oncological centers. This retrospective study aimed to present the treatment of local recurrences after HDR-BT with low-dose-rate brachytherapy (LDR-BT).Material and methods: Nine patients with low-and intermediate-risk prostate cancer with a median age of 71 years (range, 59-82 years) were diagnosed with local recurrences after previous monotherapy HDR-BT, 3 x 10.5 Gy (from 2010 to 2013). Median time to biochemical recurrence was 59 months (range, 21-80 months). All patients received 145 Gy with salvage LDR-BT (iodine-125). Gastrointestinal and urological toxicities were evaluated based on patients' records following CTCAE v. 4.0 and IPSS scales.Results: The median follow-up after salvage treatment was 30 months (range, 17-63 months). Local recurrences (LR) were detected in two cases, and the actuarial 2-year local control was 88%. Biochemical failure was observed in four cases. Distant metastases (DM) were observed in 2 patients. In one patient, both LR and DM were diagnosed si-multaneously. Four patients had no relapse of the disease, and a 2-year disease-free survival (DSF) was 58.3%. Before salvage treatment, median IPSS scores were 6.5 points (range, 1-23 points). At the first follow-up visit, after one month, the mean IPSS score was 20 points, and at the last follow-up visit, it was 8 points (range, 1-26 points). One patient had urinary retention after treatment. There was no significant change in IPSS scores before and after the treatment (p = 0.68). Two patients had grade 1 toxicity in the gastrointestinal tract.Conclusions: Salvage LDR-BT for patients with prostate cancer previously treated with HDR-BT monotherapy is characterized by acceptable toxicity, and may result in local disease control.
引用
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页码:103 / 109
页数:7
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