open access

Vol 25, No 4 (2020)
Original research articles
Published online: 2020-07-01
Submitted: 2020-01-29
Get Citation

Impact of real-time, dose-escalated permanent seed implant brachytherapy in intermediate-risk prostate cancer

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
DOI: 10.1016/j.rpor.2020.04.014
·
Rep Pract Oncol Radiother 2020;25(4):463-469.

open access

Vol 25, No 4 (2020)
Original research articles
Published online: 2020-07-01
Submitted: 2020-01-29

Abstract

Purpose

To retrospectively evaluate biochemical control and toxicity in patients who underwent 125I seed brachytherapy (BT) for intermediate-risk prostate cancer (PCa).

Materials and Methods

Between January 2004-December 2014, 395 patients with intermediate-risk PCa underwent 125I BT. Of these, 117 underwent preoperative planning (PP; 145 Gy) and 278 real-time intraoperative preplanning (IoP; 160 Gy). All patients were followed for ≥ 6 months (> 5 years in 48% of patients and > 7 years in 13%). Median follow-up was 59 months.

Results

Biochemical relapse-free survival (BRFS) rates at 5 and 8 years were, respectively, 91.7% and 82.1%. By treatment group, the corresponding BRFS rates were 93.5% and 90% for IoP and 89% and 76.8% for PP. The maximum dose to the urethra remained unchanged (217 Gy) despite the dose escalation (from 145 to 160 Gy), without any significant increase in treatment-related toxicity (p = 0.13). Overall toxicity outcomes in the series were excellent, with only 3 cases (0.76%) of grade 3 genitourinary toxicity.

Conclusion

The real-time intraoperative planning technique at 160 Gy yields better biochemical controls than the preoperative planning technique at 145 Gy. Dose escalation did not increase urinary toxicity. The excellent results obtained with the IoP BT technique support its use as the first treatment option in this patient population.

Abstract

Purpose

To retrospectively evaluate biochemical control and toxicity in patients who underwent 125I seed brachytherapy (BT) for intermediate-risk prostate cancer (PCa).

Materials and Methods

Between January 2004-December 2014, 395 patients with intermediate-risk PCa underwent 125I BT. Of these, 117 underwent preoperative planning (PP; 145 Gy) and 278 real-time intraoperative preplanning (IoP; 160 Gy). All patients were followed for ≥ 6 months (> 5 years in 48% of patients and > 7 years in 13%). Median follow-up was 59 months.

Results

Biochemical relapse-free survival (BRFS) rates at 5 and 8 years were, respectively, 91.7% and 82.1%. By treatment group, the corresponding BRFS rates were 93.5% and 90% for IoP and 89% and 76.8% for PP. The maximum dose to the urethra remained unchanged (217 Gy) despite the dose escalation (from 145 to 160 Gy), without any significant increase in treatment-related toxicity (p = 0.13). Overall toxicity outcomes in the series were excellent, with only 3 cases (0.76%) of grade 3 genitourinary toxicity.

Conclusion

The real-time intraoperative planning technique at 160 Gy yields better biochemical controls than the preoperative planning technique at 145 Gy. Dose escalation did not increase urinary toxicity. The excellent results obtained with the IoP BT technique support its use as the first treatment option in this patient population.

Get Citation

Keywords

Cancer prostate; Brachytherapy; Permanent implant; Seed I125

About this article
Title

Impact of real-time, dose-escalated permanent seed implant brachytherapy in intermediate-risk prostate cancer

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 25, No 4 (2020)

Pages

463-469

Published online

2020-07-01

DOI

10.1016/j.rpor.2020.04.014

Bibliographic record

Rep Pract Oncol Radiother 2020;25(4):463-469.

Keywords

Cancer prostate
Brachytherapy
Permanent implant
Seed I125

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

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: journals@viamedica.pl