Robert B Den1, Jacob Greenspan2, Laura A Doyle2, Amy S Harrison2, Cheng Peng2, Noelle L Williams3, Costas D Lallas4, Edouard J Trabulsi4, Leonard G Gomella4, Mark D Hurwitz2, Benjamin Leiby5, Adam P Dicker2. 1. Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA. Electronic address: Robert.den@jefferson.edu. 2. Department of Radiation Oncology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA. 3. Southeast Radiation Oncology Group, Levine Cancer Institute, Charlotte, NC. 4. Department of Urology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA. 5. Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA.
Abstract
PURPOSE: High dose-rate (HDR) brachytherapy is commonly administered as a boost to external beam radiation therapy (EBRT). Our purpose was to compare toxicity with increasingly hypofractionated EBRT in combination with a single 15 Gy HDR boost for men with intermediate-risk prostate cancer. METHODS AND MATERIALS: Forty-two men were enrolled on this phase IB clinical trial to one of three EBRT dose cohorts: 10 fractions, seven fractions, or five fractions. Patients were followed prospectively for safety, efficacy, and health-related quality of life (Expanded Prostate Index Composite). Efficacy was assessed biochemically using the Phoenix definition. RESULTS: With a median follow up of 36 months, the biochemical disease-free survival was 95.5%. One man developed metastatic disease at 5 years. There was no significant minimally important difference in EPIC PRO for either urinary, bowel, or sexual domains. There was one acute Grade 3 GI and GU toxicity, but no late Grade 3 GU or GI toxicities. CONCLUSION: Fifteen gray HDR brachytherapy followed by a five fraction SBRT approach results in high disease control rates and low toxicity similar to previously reported HDR protocols with significant improvement in patient convenience and resource savings. While mature results with longer follow up are awaited, this treatment approach may be considered a safe and effective option for men with intermediate-risk disease.
PURPOSE: High dose-rate (HDR) brachytherapy is commonly administered as a boost to external beam radiation therapy (EBRT). Our purpose was to compare toxicity with increasingly hypofractionated EBRT in combination with a single 15 Gy HDR boost for men with intermediate-risk prostate cancer. METHODS AND MATERIALS: Forty-two men were enrolled on this phase IB clinical trial to one of three EBRT dose cohorts: 10 fractions, seven fractions, or five fractions. Patients were followed prospectively for safety, efficacy, and health-related quality of life (Expanded Prostate Index Composite). Efficacy was assessed biochemically using the Phoenix definition. RESULTS: With a median follow up of 36 months, the biochemical disease-free survival was 95.5%. One man developed metastatic disease at 5 years. There was no significant minimally important difference in EPIC PRO for either urinary, bowel, or sexual domains. There was one acute Grade 3 GI and GU toxicity, but no late Grade 3 GU or GI toxicities. CONCLUSION: Fifteen gray HDR brachytherapy followed by a five fraction SBRT approach results in high disease control rates and low toxicity similar to previously reported HDR protocols with significant improvement in patient convenience and resource savings. While mature results with longer follow up are awaited, this treatment approach may be considered a safe and effective option for men with intermediate-risk disease.
Authors: Lucas C Mendez; Andrew J Arifin; Glenn S Bauman; Vikram M Velker; Belal Ahmad; Michael Lock; Varagur M Venkatesan; Tracy L Sexton; George B Rodrigues; Jeff Chen; Bryan Schaly; Andrew Warner; David P D'Souza Journal: BMC Cancer Date: 2020-10-09 Impact factor: 4.430
Authors: Christina Phuong; Jason W Chan; Lisa Ni; Phillip Wall; Osama Mohamad; Anthony C Wong; I-Chow Hsu; Albert J Chang Journal: Radiat Oncol Date: 2022-01-20 Impact factor: 3.481