open access

Vol 23, No 4 (2018)
Original research articles
Published online: 2018-07-01
Submitted: 2017-10-27
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Permanent seed implant brachytherapy in low-risk prostate cancer: Preoperative planning with 145 Gy versus real-time intraoperative planning with 160 Gy

Olga Pons-Llanas, Susana Roldan-Ortega, Francisco Celada-Alvarez, María José Perez-Calatayud, Victoria Fornes-Ferrer, Alejandro Tormo-Micó, José Perez-Calatayud, José Luis López-Torrecilla
DOI: 10.1016/j.rpor.2018.06.009
·
Rep Pract Oncol Radiother 2018;23(4):290-297.

open access

Vol 23, No 4 (2018)
Original research articles
Published online: 2018-07-01
Submitted: 2017-10-27

Abstract

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.

Abstract

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.

Get Citation

Keywords

Cancer prostate; Brachytherapy; Permanent implant; Seed I125

About this article
Title

Permanent seed implant brachytherapy in low-risk prostate cancer: Preoperative planning with 145 Gy versus real-time intraoperative planning with 160 Gy

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 23, No 4 (2018)

Pages

290-297

Published online

2018-07-01

DOI

10.1016/j.rpor.2018.06.009

Bibliographic record

Rep Pract Oncol Radiother 2018;23(4):290-297.

Keywords

Cancer prostate
Brachytherapy
Permanent implant
Seed I125

Authors

Olga Pons-Llanas
Susana Roldan-Ortega
Francisco Celada-Alvarez
María José Perez-Calatayud
Victoria Fornes-Ferrer
Alejandro Tormo-Micó
José Perez-Calatayud
José Luis López-Torrecilla

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