Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-19T02:29:12.213Z Has data issue: false hasContentIssue false

High-dose-rate brachytherapy boost in prostate cancer: a New Zealand case series

Published online by Cambridge University Press:  23 December 2015

John K. L. Chin*
Affiliation:
Department of Radiation Oncology, Waikato Regional Cancer Centre, Waikato Hospital, Hamilton, New Zealand
Kenanao D. Rantshilane
Affiliation:
Department of Radiation Oncology, Waikato Regional Cancer Centre, Waikato Hospital, Hamilton, New Zealand
Paul K. L. Chin
Affiliation:
Department of Medicine, University of Otago, Christchurch, New Zealand
Anupam Chaudhuri
Affiliation:
Department of Radiation Oncology, Waikato Regional Cancer Centre, Waikato Hospital, Hamilton, New Zealand
Leanne K. Tyrie
Affiliation:
Department of Radiation Oncology, Waikato Regional Cancer Centre, Waikato Hospital, Hamilton, New Zealand
Cristian G. Hartopeanu
Affiliation:
Department of Radiation Oncology, Waikato Regional Cancer Centre, Waikato Hospital, Hamilton, New Zealand
*
Correspondence to: John Chin, Department of Radiation Oncology, Waikato Hospital, Pembroke Street, Private Bag 3200, Hamilton 3240, New Zealand. Tel: 6 407 839 8899. Fax: 6 407 839 8799. E-mail: [email protected]

Abstract

Aim

The aim of the present study was to report the survival outcomes and late toxicity of high-dose-rate brachytherapy (HDRBT) boost for dose escalation in patients with intermediate-to-high-risk prostate cancer.

Materials and methods

Retrospective data were collected from 137 patients who had undergone definitive radiotherapy for prostate cancer between 2006 and 2010. All patients had external-beam radiotherapy (median dose 46Gy) and HDRBT. Brachytherapy dose was 19Gy in two fractions (6 hours apart) with one implant using Ir-192.

Results

There were 94 high-risk and 43 intermediate-risk patients (NCCN classification). The median follow-up period was 60 months. The 5-year biochemical progression-free survival was 92 and 76% for intermediate- and high-risk groups, respectively. Prostate cancer-specific survival for the intermediate-risk group was 100% and for the high-risk group it was 92% at 5 years. For the entire cohort, the 5-year rate of urethral stricture formation was 13%, and the 5-year rate of late grade 2 and grade 3 gastrointestinal toxicity was 4·7 and 4·6%, respectively. There was no grade 3 or greater genitourinary toxicity.

Findings

Our data add to the growing body of literature supporting the use of HDRBT in prostate cancer. Late toxicity rates were marginally higher than that expected.

Type
Original Articles
Copyright
© Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Ferlay, J, Soerjomataram, I, Ervik, M et al. GLOBOCAN 2012: estimated cancer incidence, mortality and prevalence worldwide in 2012. World Health Organization, 2012. http://www.iarc.fr/. Accessed on 1st January, 2014.Google Scholar
2.Zelefsky, MJ, Yamada, Y, Fuks, Zet al. Long-term results of conformal radiotherapy for prostate cancer: impact of dose escalation on biochemical tumor control and distant metastases-free survival outcomes. Int J Radiat Oncol Biol Phys 2008; 71: 10281033.CrossRefGoogle ScholarPubMed
3.Zelefsky, MJ, Chan, H, Hunt, M, Yamada, Y, Shippy, AM, Amols, H. Long-term outcome of high dose intensity modulated radiation therapy for patients with clinically localized prostate cancer. J Urol 2006; 176: 14151419.CrossRefGoogle ScholarPubMed
4.Pollack, A, Zagars, GK, Starkschall, Get al. Prostate cancer radiation dose response: results of the M. D. Anderson phase III randomized trial. Int J Radiat Oncol Biol Phys 2002; 53: 10971105.CrossRefGoogle Scholar
5.Hoskin, PJ, Motohashi, K, Bownes, P, Bryant, L, Ostler, P. High dose rate brachytherapy in combination with external beam radiotherapy in the radical treatment of prostate cancer: initial results of a randomised phase three trial. Radiother Oncol 2007; 84: 114120.CrossRefGoogle ScholarPubMed
6.Bachand, F, Martin, AG, Beaulieu, L, Harel, F, Vigneault, E. An eight-year experience of HDR brachytherapy boost for localized prostate cancer: biopsy and PSA outcome. Int J Radiat Oncol Biol Phys 2009; 73: 679684.CrossRefGoogle ScholarPubMed
7.Williams, SG, Taylor, JM, Liu, Net al. Use of individual fraction size data from 3756 patients to directly determine the alpha/beta ratio of prostate cancer. Int J Radiat Oncol Biol Phys 2007; 68: 2433.CrossRefGoogle ScholarPubMed
8.Morton, G. The best method for dose escalation: prostate brachytherapy. Can Urol Assoc J 2012; 6: 196198.CrossRefGoogle ScholarPubMed
9.Sathya, JR, Davis, IR, Julian, JAet al. Randomized trial comparing iridium implant plus external-beam radiation therapy with external-beam radiation therapy alone in node-negative locally advanced cancer of the prostate. J Clin Oncol 2005; 23: 11921199.CrossRefGoogle ScholarPubMed
10.Guix, B, Lacorte, T, Bartrina, Jet al. Quality of life after IMRT or IMRT+HDR brachytherapy for intermediate- or high-risk prostate cancer: 8-year results of a prospective trial. Int J Radiat Oncol Biol Phys 2013; 87: S386.CrossRefGoogle Scholar
11.Conaglen, HM, de Jong, D, Hartopeanu, C, Conaglen, JV, Tyrie, LK. The effect of high dose rate brachytherapy in combination with external beam radiotherapy on men’s health-related quality of life and sexual function over a 2 year time span. Clin Oncol (R Coll Radiol) 2013; 25: 197204.CrossRefGoogle Scholar
12.Mohler, J, Bahnson, RR, Boston, Bet al. NCCN clinical practice guidelines in oncology: prostate cancer. J Natl Compr Canc Netw 2010; 8: 162200.CrossRefGoogle ScholarPubMed
13.Hsu, IC, Bae, K, Shinohara, Ket al. Phase II trial of combined high-dose-rate brachytherapy and external beam radiotherapy for adenocarcinoma of the prostate: preliminary results of RTOG 0321. Int J Radiat Oncol Biol Phys 2010; 78: 751758.CrossRefGoogle ScholarPubMed
14.Roach, M 3rd, Hanks, G, Thames, H Jret al. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys 2006; 65: 965974.CrossRefGoogle ScholarPubMed
15.Galalae, RM, Martinez, A, Mate, Tet al. Long-term outcome by risk factors using conformal high-dose-rate brachytherapy (HDR-BT) boost with or without neoadjuvant androgen suppression for localized prostate cancer. Int J Radiat Oncol Biol Phys 2004; 58: 10481055.CrossRefGoogle ScholarPubMed
16.Zwahlen, DR, Andrianopoulos, N, Matheson, B, Duchesne, GM, Millar, JL. High-dose-rate brachytherapy in combination with conformal external beam radiotherapy in the treatment of prostate cancer. Brachytherapy 2010; 9: 2735.CrossRefGoogle ScholarPubMed
17.Whalley, D, Patanjali, N, Jackson, M, Lovett, A, Chatfield, M, Hruby, G. HDR brachytherapy combined with external beam radiation for localised prostate cancer: early experience from the Sydney Cancer Centre. J Med Imaging Radiat Oncol 2012; 56: 220226.CrossRefGoogle ScholarPubMed
18.Sullivan, L, Williams, SG, Tai, KH, Foroudi, F, Cleeve, L, Duchesne, GM. Urethral stricture following high dose rate brachytherapy for prostate cancer. Radiother Oncol 2009; 91: 232236.CrossRefGoogle ScholarPubMed
19.Mate, TP, Gottesman, JE, Hatton, J, Gribble, M, Hollebeke, LV. High dose-rate afterloading 192Iridium prostate brachytherapy: feasibility report. Int J Radiat Oncol Biol Phys 1998; 41: 525533.CrossRefGoogle ScholarPubMed
20.Takeda, K, Ogawa, Y, Ariga, Het al. Clinical correlations between treatment with anticoagulants/antiaggregants and late rectal toxicity after radiotherapy for prostate cancer. Anticancer Res 2009; 29: 18311834.Google ScholarPubMed
21.Choe, KS, Jani, AB, Liauw, SL. External beam radiotherapy for prostate cancer patients on anticoagulation therapy: how significant is the bleeding toxicity? Int J Radiat Oncol Biol Phys 2010; 76: 755760.CrossRefGoogle ScholarPubMed
22.Hamstra, DA, Conlon, AS, Daignault, Set al. Multi-institutional prospective evaluation of bowel quality of life after prostate external beam radiation therapy identifies patient and treatment factors associated with patient-reported outcomes: the PROSTQA experience. Int J Radiat Oncol Biol Phys 2013; 86: 546553.CrossRefGoogle ScholarPubMed
23.Shah, C, Lanni, TB Jr, Ghilezan, MIet al. Brachytherapy provides comparable outcomes and improved cost-effectiveness in the treatment of low/intermediate prostate cancer. Brachytherapy 2012; 11: 441445.CrossRefGoogle ScholarPubMed
24.Morton, GC, Loblaw, DA, Sankreacha, Ret al. Single-fraction high-dose-rate brachytherapy and hypofractionated external beam radiotherapy for men with intermediate-risk prostate cancer: analysis of short- and medium-term toxicity and quality of life. Int J Radiat Oncol Biol Phys 2010; 77: 811817.CrossRefGoogle Scholar