AIM: The present retrospective study was to compare toxicity and survival outcomes in a group of low-risk PCa patients treated with either the preoperative planning technique (145 Gy) or the real-time IoP technique (160 Gy). BACKGROUND: The two most common permanent seed implantation techniques are preoperative planning (PP) with 145 Gy and real-time intraoperative planning (IoP) with 160 Gy. Although IoP has largely replaced PP at many centres in recent years, few studies have directly compared these two techniques. MATERIALS AND METHODS: Retrospective study of 408 patients with low-risk PCa treated with permanent seed implant brachytherapy at our institution between October 2003 and December 2014. Of these, 187 patients were treated with PP at a dose of 145 Gy while 221 received real-time IoP with 160 Gy. RESULTS: At a median follow up of 90 months, 5- and 8-year rates of biochemical relapse-free survival (BRFS) were 94.8% and 86% with the IoP technique versus 90.8% and 83.9%, respectively, with PP. The maximum dose to the urethra was <217 Gy with both techniques. Despite the higher dose, IoP did not cause any significant increase in toxicity (p = 0.11). CONCLUSIONS: The present study shows that real-time intraoperative brachytherapy at a dose of 160 Gy yield better biochemical control than preoperative planning at 145 Gy. In addition, urinary toxicity did not increase, despite the dose escalation, probably because the dose constraints to the urethra were met despite the increased dose escalation. These findings support the use of real-time IoP.
AIM: The present retrospective study was to compare toxicity and survival outcomes in a group of low-risk PCa patients treated with either the preoperative planning technique (145 Gy) or the real-time IoP technique (160 Gy). BACKGROUND: The two most common permanent seed implantation techniques are preoperative planning (PP) with 145 Gy and real-time intraoperative planning (IoP) with 160 Gy. Although IoP has largely replaced PP at many centres in recent years, few studies have directly compared these two techniques. MATERIALS AND METHODS: Retrospective study of 408 patients with low-risk PCa treated with permanent seed implant brachytherapy at our institution between October 2003 and December 2014. Of these, 187 patients were treated with PP at a dose of 145 Gy while 221 received real-time IoP with 160 Gy. RESULTS: At a median follow up of 90 months, 5- and 8-year rates of biochemical relapse-free survival (BRFS) were 94.8% and 86% with the IoP technique versus 90.8% and 83.9%, respectively, with PP. The maximum dose to the urethra was <217 Gy with both techniques. Despite the higher dose, IoP did not cause any significant increase in toxicity (p = 0.11). CONCLUSIONS: The present study shows that real-time intraoperative brachytherapy at a dose of 160 Gy yield better biochemical control than preoperative planning at 145 Gy. In addition, urinary toxicity did not increase, despite the dose escalation, probably because the dose constraints to the urethra were met despite the increased dose escalation. These findings support the use of real-time IoP.
Entities:
Keywords:
Brachytherapy; Cancer prostate; Permanent implant; Seed I125
Authors: Brian J Davis; Eric M Horwitz; W Robert Lee; Juanita M Crook; Richard G Stock; Gregory S Merrick; Wayne M Butler; Peter D Grimm; Nelson N Stone; Louis Potters; Anthony L Zietman; Michael J Zelefsky Journal: Brachytherapy Date: 2012 Jan-Feb Impact factor: 2.362
Authors: John E Sylvester; Peter D Grimm; Jason Wong; Robert W Galbreath; Gregory Merrick; John C Blasko Journal: Int J Radiat Oncol Biol Phys Date: 2010-09-23 Impact factor: 7.038
Authors: Johnny Kao; Nelson N Stone; Amir Lavaf; Vishruta Dumane; Jamie A Cesaretti; Richard G Stock Journal: Int J Radiat Oncol Biol Phys Date: 2007-11-05 Impact factor: 7.038
Authors: Jose Luis Guinot; Jose Vicente Ricós; Maria Isabel Tortajada; Miguel Angel Santos; Juan Casanova; Jose Clemente; Josefa Samper; Paula Santamaría; Leoncio Arribas Journal: J Contemp Brachytherapy Date: 2015-08-18
Authors: O Pons-Llanas; E Collado-Ballesteros; S Roldan-Ortega; A Conde-Moreno; F Celada-Alvarez; F Martínez-Arcelus; M J Pérez-Calatayud; V Carmona-Meseguer; J Gimeno-Olmos; V Forner-Ferrer; A Tormo-Micó; J Perez-Calatayud; J López-Torrecilla Journal: Rep Pract Oncol Radiother Date: 2020-05-08
Authors: O Pons-Llanas; J Burgos-Burgos; S Roldan-Ortega; A Conde-Moreno; F Celada-Alvarez; J C Ruiz-Martinez; F Lliso-Valverde; A Tormo-Micó; J Perez-Calatayud; J López-Torrecilla Journal: Rep Pract Oncol Radiother Date: 2020-07-05