PURPOSE: This work evaluates the prophylactic administration of dexamethasone as an adjunct to prostate brachytherapy to determine the effect of dexamethasone on postimplant edema, dosimetric quality, catheter dependency, and clinical outcome as assessed by serial American Urological Association (AUA) symptom score determinations. MATERIALS AND METHODS: In a controlled study, 22 unselected patients were placed alternately into either a dexamethasone or control arm. RESULTS: There was no statistically significant difference in volume between the experimental and control groups on either day 0 or day 28. Accordingly, the day 0 dosimetric parameters, short-term catheter dependency, and serial AUA symptom score determinations were equivalent in both patient groups. However, the patients receiving dexamethasone had a markedly smaller volume on day 3, but 9 of 11 experienced rebound edema with a volume on day 14 significantly greater than day 3. CONCLUSIONS: Because of the small number of patients evaluated, additional studies are essential to confirm these findings. At the present time, we do not recommend this dexamethasone schedule as a routine component of prostate brachytherapy.
RCT Entities:
PURPOSE: This work evaluates the prophylactic administration of dexamethasone as an adjunct to prostate brachytherapy to determine the effect of dexamethasone on postimplant edema, dosimetric quality, catheter dependency, and clinical outcome as assessed by serial American Urological Association (AUA) symptom score determinations. MATERIALS AND METHODS: In a controlled study, 22 unselected patients were placed alternately into either a dexamethasone or control arm. RESULTS: There was no statistically significant difference in volume between the experimental and control groups on either day 0 or day 28. Accordingly, the day 0 dosimetric parameters, short-term catheter dependency, and serial AUA symptom score determinations were equivalent in both patient groups. However, the patients receiving dexamethasone had a markedly smaller volume on day 3, but 9 of 11 experienced rebound edema with a volume on day 14 significantly greater than day 3. CONCLUSIONS: Because of the small number of patients evaluated, additional studies are essential to confirm these findings. At the present time, we do not recommend this dexamethasone schedule as a routine component of prostate brachytherapy.
Authors: Al V Taira; Gregory S Merrick; Robert W Galbreath; Mallory Morris; Wayne M Butler; Edward Adamovich Journal: J Contemp Brachytherapy Date: 2014-10-06