Clinical and translational radiation oncology · 2026
High-dose-rate monotherapy for localised prostate Cancer: A two-implant approach with median 13 years follow-up.
СтатьяНазвание и аннотация: Перевод в очереди
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Best Christopher, Spier Valentin, Baltas Dimos, Ackermann Hanns, Rödel Claus, Zamboglou Nikolaos, Tselis Nikolaos
Аннотация
OBJECTIVES: To report the clinical outcome of High-Dose-Rate (HDR) brachytherapy (BRT) as sole treatment for clinically localised prostate cancer (PCA).
METHODS: From March 2004 to January 2008, 351 consecutive patients with clinically localised PCA were treated with HDR monotherapy receiving two BRT implants, separated by 14 days, each delivering two fractions at 9.5 Gy to an intraoperative transrectal ultrasound real-time defined planning treatment volume. The present report describes the updated long-term results of this two-implant protocol. Biochemical relapse was defined according to the Phoenix definition and toxicity evaluated using the Common Toxicity Criteria for Adverse Events version 3.
RESULTS: The median follow-up for the current analysis was 158 months with 201 patients eligible for analysis. Out of the initial cohort, 62 patients died during follow-up and 150 were lost to follow-up. The 60-, 120- and 158-months biochemical control and metastasis-free survival rates were 94%, 90%, 86% and 97%, 89%, 83%, respectively. Eight (3.9%) patients developed late Grade 2-3 lower urinary tract symptoms characterized by increased urgency and frequency with no dysuria or incontinence > Grade 2. Four (2%) patients developed late Grade 3 gastrointestinal toxicity. No Grade 4 or higher acute or late toxicities occurred.
CONCLUSIONS: Our results confirm HDR-BRT to be a safe and effective monotherapy for organ-confined PCA.
METHODS: From March 2004 to January 2008, 351 consecutive patients with clinically localised PCA were treated with HDR monotherapy receiving two BRT implants, separated by 14 days, each delivering two fractions at 9.5 Gy to an intraoperative transrectal ultrasound real-time defined planning treatment volume. The present report describes the updated long-term results of this two-implant protocol. Biochemical relapse was defined according to the Phoenix definition and toxicity evaluated using the Common Toxicity Criteria for Adverse Events version 3.
RESULTS: The median follow-up for the current analysis was 158 months with 201 patients eligible for analysis. Out of the initial cohort, 62 patients died during follow-up and 150 were lost to follow-up. The 60-, 120- and 158-months biochemical control and metastasis-free survival rates were 94%, 90%, 86% and 97%, 89%, 83%, respectively. Eight (3.9%) patients developed late Grade 2-3 lower urinary tract symptoms characterized by increased urgency and frequency with no dysuria or incontinence > Grade 2. Four (2%) patients developed late Grade 3 gastrointestinal toxicity. No Grade 4 or higher acute or late toxicities occurred.
CONCLUSIONS: Our results confirm HDR-BRT to be a safe and effective monotherapy for organ-confined PCA.