High-dose-rate brachytherapy plus external beam radiotherapy for T1 to T3 prostate cancer: An experience in Taiwan

被引:20
作者
Chen, Yen-Chao
Chuang, Cheng-Keng
Hsieh, Ming-Li
Chen, Wen-Cheng
Fan, Kang-Hsing
Yeh, Chie-Yi
Lee, Chung-Chi
Hong, Ji-Hong
机构
[1] Chang Gung Univ, Chang Gung Mem Hosp, Dept Radiat Oncol, Tao Yuan, Taiwan
[2] Chang Gung Univ, Chang Gung Mem Hosp, Dept Urol, Tao Yuan, Taiwan
[3] Chang Gung Mem Hosp, Dept Radiat Oncol, Chiayi, Taiwan
[4] Chang Gung Univ, Dept Med Imaging & Radiol Sci, Tao Yuan, Taiwan
关键词
RADIATION-THERAPY; RISK; MEN;
D O I
10.1016/j.urology.2007.03.008
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES To report outcomes for localized prostate cancer patients treated with the combination of high-dose-rate (HDR) brachytherapy and external beam radiotherapy (EBRT). METHODS Eighty-five Stage T1c to T3b prostate cancer patients treated with HDR brachytherapy Plus EBRT were included. An HDR dose of 16.5 Gy in 3 fractions over 24 hours was given 2 weeks before EBRT. An EBRT dose of 50.4 Gy was administered to the prostate and seminal vesicles. Younger patients (aged less than 75 years) with greater than 15% risk of nodal metastasis received whole-pelvis RT (45 Gy in 25 fractions) as part of EBRT. RESULTS Fifty percent of patients belonged to the high-risk (T3a or Gleason score 8-10 or prostate-specific antigen greater than 20 ng/mL) or very-high-risk (T3b) groups. After a median follow-up of 49 months (range, 24 to 70 months), 4-year biochemical control survival (less than nadir + 2) was 86% (100%, 91%, and 81% for patients in the tow, intermediate, and high-risk groups, respectively. Three Of four T3b patients experienced early biochemical failure. Four patients (5%) had grade 3 implant-related urinary retention. Chronic gastrointestinal toxicities were limited, but four grade 3 chronic genitourinary toxicities (5%) were noted in relation to urethral stricture and severe hematuria. Whole-pelvis EBRT was a major contributing factor to acute but not to chronic gastrointestinal toxicities. Among 60 patients with pretreatment sexual potency, 17 (26%) retained capability after 4 years. Six patients (10%) lost potency merely as a result of salvage hormone therapy. CONCLUSIONS High-dose-rate brachytherapy plus EBRT can achieve satisfactory biochemical control with acceptable complications for T1c to T3a prostate cancer patients.
引用
收藏
页码:101 / 105
页数:5
相关论文
共 29 条
[1]   Brachytherapy for carcinoma of the prostate: Techniques, patient selection, and clinical outcomes [J].
Blasko, JC ;
Mate, T ;
Sylvester, JE ;
Grimm, PD ;
Cavanagh, W .
SEMINARS IN RADIATION ONCOLOGY, 2002, 12 (01) :81-94
[2]  
Brenner DJ, 2002, INT J RADIAT ONCOL, V52, P6
[3]   The changing face of low-risk prostate cancer: Trends in clinical presentation and primary management [J].
Cooperberg, MR ;
Lubeck, DP ;
Meni, MV ;
Mehta, SS ;
Carroll, PR .
JOURNAL OF CLINICAL ONCOLOGY, 2004, 22 (11) :2141-2149
[4]   High dose rate brachytherapy of localized prostate cancer [J].
Deger, S ;
Boehmer, D ;
Türk, I ;
Roigas, J ;
Wernecke, KD ;
Wiegel, T ;
Hinkelbein, W ;
Dinges, S ;
Budach, V ;
Loening, SA .
EUROPEAN UROLOGY, 2002, 41 (04) :420-426
[5]   High-dose-rate intensity-modulated brachytherapy with external beam radiotherapy for prostate cancer: California endocurietherapy's 10-year results [J].
Demanes, DJ ;
Rodriguez, RR ;
Schour, L ;
Brandt, D ;
Altieri, G .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2005, 61 (05) :1306-1316
[6]   Long-term outcome after elective irradiation of the pelvic lymphatics and local dose escalation using high-dose-rate brachytherapy for locally advanced prostate cancer [J].
Galalae, RM ;
Kovács, G ;
Schultze, J ;
Loch, T ;
Rzehak, P ;
Wilhelm, R ;
Bertermann, H ;
Buschbeck, B ;
Kohr, P ;
Kimmig, B .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2002, 52 (01) :81-90
[7]   Racial differences in mortality among Medicare recipients after treatment for localized prostate cancer [J].
Godley, PA ;
Schenck, AP ;
Amamoo, MA ;
Schoenbach, VJ ;
Peacock, S ;
Manning, M ;
Symons, M ;
Talcott, JA .
JNCI-JOURNAL OF THE NATIONAL CANCER INSTITUTE, 2003, 95 (22) :1702-1710
[8]   Clinical results of combined treatment conformal high-dose-rate iridium-192 brachytherapy and external beam radiotherapy using staging lymphadenectomy for localized prostate cancer [J].
Hiratsuka, J ;
Jo, Y ;
Yoshida, K ;
Nagase, N ;
Fujisawa, M ;
Imajo, Y .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2004, 59 (03) :684-690
[9]   High dose rate afterloading brachytherapy for prostate cancer: catheter and gland movement between fractions [J].
Hoskin, PJ ;
Bownes, PJ ;
Ostler, P ;
Walker, K ;
Bryant, L .
RADIOTHERAPY AND ONCOLOGY, 2003, 68 (03) :285-288
[10]   Sexual (dys)function after radiotherapy for prostate cancer: A review [J].
Incrocci, L ;
Slob, AK ;
Levendag, PC .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2002, 52 (03) :681-693