Toxicity and risk factors after combined high-dose-rate brachytherapy and external beam radiation therapy in men ≥75 years with localized prostate cancer; [Toxizität und Risikofaktoren nach kombinierter Hochdosis-Brachytherapie und perkutaner Bestrahlung bei Männern ≥75 Jahren mit lokalisiertem Prostatakarzinom]

被引：0

作者：

Löser A. ^{[1
]}

Beyer B. ^{[2
]}

Carl C.O. ^{[1
]}

Löser B. ^{[3
]}

Nagaraj Y. ^{[2
]}

Frenzel T. ^{[1
]}

Petersen C. ^{[4
]}

Krüll A. ^{[1
]}

Graefen M. ^{[2
]}

Schwarz R. ^{[1
]}

机构：

[1] Department of Radiotherapy and Radiooncology, Outpatient Center, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg

[2] Martini-Klinik, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg

[3] Department of Anaesthesiology, Center of Anaesthesiology and Intensive Care Medicine, University Medicine Rostock, Schillingallee 35, Rostock

[4] Department of Radiotherapy and Radiooncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg

来源：

Strahlentherapie und Onkologie | 2019年 / 195卷 / 5期

关键词：

Biochemical recurrence; Brachytherapy; External beam radiotherapy; Old patients; Prostate cancer;

D O I：

10.1007/s00066-018-1380-5

中图分类号：

学科分类号：

摘要：

Purpose: Combined high-dose-rate brachytherapy (HDR-BT) and external beam radiation therapy (EBRT) is a favorable treatment option in non-metastatic prostate cancer. However, reports on toxicity and outcome have mainly focused on younger patients. We aimed to determine toxicity and biochemical control rates after combined HDR-BT and EBRT in men ≥75 years. Methods: From 1999 to 2015, 134 patients aged ≥75 years (median 76 years; 75–82 years) were identified. Patients received 18 Gy of HDR-BT (9 Gy/fraction on days 1 and 8) with an iridium-192 source. After 1 week, supplemental EBRT with a target dose of 50.4 Gy was started (delivered in 1.8 Gy fractions). Results: Median follow-up time was 25 months (0–127 months). No severe (grade 4) gastrointestinal (GIT) or genitourinary (GUT) toxicities were observed. In 76 patients (56.7%), 3D conformal radiation therapy (CRT) and in 34.3% intensity-modulated radiotherapy (IMRT) was applied. CRT-treated patients were at a 2.17-times higher risk (hazard ratio [HR]: 2.17, 95% confidence interval [CI]: 1.31–3.57, p = 0.002) of experiencing GUT. GIT risks could be reduced by 78% using IMRT (HR: 0.22, 95% CI: 0.07–0.75, p = 0.015). Patients with a higher T stage (T2c–3a/b) were less likely to experience GIT or GUT (HR: 0.49, 95% CI: 0.29–0.85, p = 0.011 and HR: 0.5, 95% CI: 0.3–0.81, p = 0.005, respectively). Conclusion: HDR-BT/EBRT is a well-tolerated treatment option for elderly men ≥75 years with a limited number of comorbidities and localized intermediate- or high-risk prostate cancer. IMRT should be favored since side effects were significantly reduced in IMRT-treated patients. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.

引用

页码：374 / 382

页数：8

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