Atsushi Mizokami md phd, Department of Urology, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa-city 920-8640, Japan. Email: [email protected]

Read the full text

About

PDF

Tools

Share a link

Email
Wechat
Bluesky

Abstract

Background: We evaluated the efficacy and complications of high dose rate (HDR) brachytherapy using iridium-192 (¹⁹²Ir) combined with external beam radiotherapy (EBRT) in patients with prostate cancer.

Methods: Ninety-seven patients underwent ¹⁹²Ir HDR brachytherapy combined with EBRT at our institution between February 1999 and December 2003. Of these, 84 patients were analysed in the present study. ¹⁹²Ir was delivered three times over a period of 2 days, 6 Gy per time, for a total dose of 18 Gy. Interstitial application was followed by EBRT at a dose of 44 Gy. Progression was defined as three consecutive prostate-specific antigen (PSA) rises after a nadir according to the American Society for Therapeutic Radiology and Oncology criteria. The results were classified into those for all patients and for patients who did not undergo adjuvant hormone therapy.

Results: The 4-year overall survival of all patients, the nonadjuvant hormone therapy group (NAHT) and the adjuvant hormone therapy group (AHT) was 87.2%, 100%, and 70.1%, respectively. The PSA progression-free survival rate of all patients, NAHT, and AHT was 82.6%, 92.0%, and 66.6%, respectively. Of all patients, the 4-year PSA progression-free survival rates of PSA < 20 and PSA ≥ 20 groups were 100%, and 46.8%, respectively. According to the T stage classification, PSA progression-free survival rates of T1c, T2, T3, and T4 were 100%, 82.8%, 100%, and 12.1%, respectively. Prostate-specific antigen progression-free survival rates of groups with Gleason scores (GS) < 7 and GS ≥ 7 were 92.8% and 60.1%, respectively. Of NAHT, PSA progression-free survival of PSA < 20 was 100% vs 46.8% for PSA ≥ 20, that of T1c was 100% vs 75% for T2, and that of GS < 7 was 100% vs 75% for GS ≥ 7. No significant intraoperative or postoperative complications requiring urgent treatment occurred except cerebellum infarction.

Conclusions: ¹⁹²Ir HDR brachytherapy combined with EBRT was as effective as radical prostatectomy and had few associated complications.

References

1 Hinotsu S, Akaza H. Zenritsusengan no ekigaku. Jap. J. Clin. Urol. 2003; 57: 151–6.
Google Scholar
2 Hull GW, Rabbani F, Abbas F et al. Cancer control with radical prostatectomy alone in 1000 consecutive patients. J. Urol. 2002; 167: 528–34.
10.1016/S0022-5347(01)69079-7
PubMed Web of Science® Google Scholar
3 Dugan TC, Shipley WU, Young RH et al. Biopsy after external beam radiation therapy for adenocarcinoma of the prostate: correlation with original histological grade and current prostate specific antigen levels. J. Urol. 1991; 146: 1313–16.
10.1016/S0022-5347(17)38077-1
CAS PubMed Web of Science® Google Scholar
4 Akakura K, Isaka S, Akimoto S et al. Long-term results of a randomized trial for the treatment of Stages B2 and C prostate cancer: radical prostatectomy versus external beam radiation therapy with a common endocrine therapy in both modalities. Urology 1999; 54: 313–18.
10.1016/S0090-4295(99)00106-5
CAS PubMed Web of Science® Google Scholar
5 Syed AM, Puthawala A, Sharma A et al. High-dose-rate brachytherapy in the treatment of carcinoma of the prostate. Cancer Control 2001; 8: 511–21.
10.1177/107327480100800606
CAS PubMed Google Scholar
6 Vicini F, Vargas C, Gustafson G, Edmundson G, Martinez A. High dose rate brachytherapy in the treatment of prostate cancer. World J. Urol. 2003; 21: 220–8.
10.1007/s00345-003-0358-8
PubMed Web of Science® Google Scholar
7 Stromberg J, Martinez A, Gonzalez J et al. Ultrasound-guided high dose rate conformal brachytherapy boost in prostate cancer: treatment description and preliminary results of a phase I/II clinical trial. Int. J. Radiat. Oncol. Biol. Phys. 1995; 33: 161–71.
10.1016/0360-3016(95)00035-W
CAS PubMed Web of Science® Google Scholar
8 Partin AW, Kattan MW, Subong EN et al. Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancer. A multi-institutional update. JAMA 1997; 277: 1445–51.
10.1001/jama.1997.03540420041027
CAS PubMed Web of Science® Google Scholar
9 Kasahara K, Inoue K, Karashima T et al. High-dose rate iridium-192 brachytherapy combined with external beam radiotherapy for localized prostate cancer. Nippon Hinyokika Gakkai Zasshi 2001; 92: 572–8.
CAS PubMed Google Scholar
10 Saito S, Momma T, Dokiya T, Murai M. Brachytherapy for prostate cancer in Japan. Int. J. Urol. 2001; 8: S22–7.
10.1046/j.1442-2042.2001.00330.x
CAS PubMed Web of Science® Google Scholar
11 Egawa S. Brachytherapy for prostate cancer: permanent seed implantation versus HDR temporary brachytherapy. Jap. J. Urol. Surg. 2004; 17: 293–9.
Google Scholar
12 Kitagawa Y, Koshida K, Mizokami A et al. Pathological effects of neoadjuvant hormonal therapy help predict progression of prostate cancer after radical prostatectomy. Int. J. Urol. 2003; 10: 377–82.
10.1046/j.1442-2042.2003.00640.x
CAS PubMed Web of Science® Google Scholar
13 Lee WR, Hanks GE, Schultheiss TE, Corn BW, Hunt MA. Localized prostate cancer treated by external-beam radiotherapy alone: serum prostate-specific antigen – driven outcome analysis. J. Clin. Oncol. 1995; 13: 464–9.
10.1200/JCO.1995.13.2.464
CAS PubMed Web of Science® Google Scholar
14 Zagars GK, Pollack A, Kavadi VS, von Eschenbach AC. Prostate-specific antigen and radiation therapy for clinically localized prostate cancer. Int. J. Radiat. Oncol. Biol. Phys. 1995; 32: 293–306.
10.1016/0360-3016(95)00077-C
CAS PubMed Web of Science® Google Scholar
15 Pisansky TM, Kahn MJ, Rasp GM, Cha SS, Haddock MG, Bostwick DG. A multiple prognostic index predictive of disease outcome after irradiation for clinically localized prostate carcinoma. Cancer 1997; 79: 337–44.
10.1002/(SICI)1097-0142(19970115)79:2<337::AID-CNCR17>3.0.CO;2-1
CAS PubMed Web of Science® Google Scholar
16 Grills IS, Martinez AA, Hollander M et al. High dose rate brachytherapy as prostate cancer monotherapy reduces toxicity compared to low dose rate palladium seeds. J. Urol. 2004; 171: 1098–104.
10.1097/01.ju.0000113299.34404.22
PubMed Web of Science® Google Scholar
17 Holm HH, Juul N, Pedersen JF, Hansen H, Stroyer I. Transperineal 125iodine seed implantation in prostatic cancer guided by transrectal ultrasonography. J. Urol. 1983; 130: 283–6.
10.1016/S0022-5347(17)51108-8
CAS PubMed Web of Science® Google Scholar
18 Martinez AA, Pataki I, Edmundson G, Sebastian E, Brabbins D, Gustafson G. Phase II prospective study of the use of conformal high-dose-rate brachytherapy as monotherapy for the treatment of favorable stage prostate cancer: a feasibility report. Int. J. Radiat. Oncol. Biol. Phys. 2001; 49: 61–9.
10.1016/S0360-3016(00)01463-2
CAS PubMed Web of Science® Google Scholar
19 Ragde H, Blasko JC, Grimm PD et al. Brachytherapy for clinically localized prostate cancer: results at 7- and 8-year follow-up. Semin. Surg. Oncol. 1997; 13: 438–43.
10.1002/(SICI)1098-2388(199711/12)13:6<438::AID-SSU8>3.0.CO;2-B
CAS PubMed Web of Science® Google Scholar
20 Weyrich TP, Kandzari SJ, Jain PR. Iodine 125 seed implants for prostatic carcinoma. Five- and ten-year follow-up. Urology 1993; 41: 122–6.
10.1016/0090-4295(93)90160-C
CAS PubMed Web of Science® Google Scholar
21 Deger S, Boehmer D, Turk I et al. High dose rate brachytherapy of localized prostate cancer. Eur. Urol. 2002; 41: 420–6.
10.1016/S0302-2838(02)00016-7
PubMed Web of Science® Google Scholar
22 Kovacs G, Galalae R, Loch T et al. Prostate preservation by combined external beam and HDR brachytherapy in nodal negative prostate cancer. Strahlenther. Onkol. 1999; 175 (Suppl. 2): 87–8.
10.1007/BF03038899
PubMed Web of Science® Google Scholar

Citing Literature

Volume13, Issue2

February 2006

Pages 116-121

Four year clinical statistics of iridium-192 high dose rate brachytherapy

Abstract

References

Citing Literature

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Four year clinical statistics of iridium-192 high dose rate brachytherapy

Abstract

References

Citing Literature

References

Related

Information