American Brachytherapy Society-Groupe Europeen de Curietherapie-European Society of Therapeutic Radiation Oncology (ABS-GEC-ESTRO) consensus statement for penile brachytherapy

PURPOSE: To develop a consensus statement between the American Brachytherapy Society (ABS) and Groupe Europeen de Curietherapie/European Society for Therapeutic Radiation and Oncology (GEC-ESTRO) for the use of brachytherapy in the primary management of carcinoma of the penis. METHODS AND MATERIALS: The American Brachytherapy Society and Groupe Europeen de Curietherapie/European Society for Therapeutic Radiation and Oncology convened a group of expert practitioners and physicists to develop a statement for the use of Ir-192 in low-dose-rate (LDR), pulse-dose-rate, and high-dose-rate (HDR) brachytherapy for penile cancer. RESULTS: Decades of brachytherapy experience with LDR Ir-192 wire and pulse-dose-rate Ir-192 sources for this rare malignancy indicate a penile preservation rate of 70% at 10 years postimplant. Chief morbidities remain stenosis of the urethral meatus and soft tissue ulceration at the primary site. Nonhealing ulceration can be successfully managed with various measures including hyperbaric oxygen treatment. HDR brachytherapy implant procedures are technically similar to LDR. The optimal HDR dose and fractionation schemes are being developed. CONCLUSIONS: The good tumor control rates, acceptable morbidity, and functional organ preservation warrant recommendation of brachytherapy as the initial treatment for invasive T1, T2, and selected T3 penile cancers. (C) 2013 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.