Purpose: High-dose-rate (HDR) brachytherapy used as the only treatment (monotherapy) for early prostate cancer is consistent with current concepts in prostate radiobiology, and the dose is reliably delivered in a prospectively defined anatomic distribution that meets all the requirements for safe and effective therapy. We report the disease control and toxicity of HDR monotherapy from California Endocurietherapy (CET) and William Beaumont Hospital (WBH) in low- and intermediate-risk prostate cancer patients.
Methods And Materials: There were 298 patients with localized prostate cancer treated with HDR monotherapy between 1996 and 2005. Two biologically equivalent hypofractionation protocols were used. At CET the dose was 42 Gy in six fractions (two implantations 1 week apart) delivered to a computed tomography-defined planning treatment volume. At WBH the dose was 38 Gy in four fractions (one implantation) based on intraoperative transrectal ultrasound real-time treatment planning. The bladder, urethral, and rectal dose constraints were similar. Toxicity was scored with the National Cancer Institute Common Toxicity Criteria for Adverse Events version 3.
Results: The median follow-up time was 5.2 years. The median age of the patients was 63 years, and the median value of the pretreatment prostate-specific antigen was 6.0 ng/mL. The 8-year results were 99% local control, 97% biochemical control (nadir +2), 99% distant metastasis-free survival, 99% cause-specific survival, and 95% overall survival. Toxicity was scored per event, meaning that an individual patient with more than one symptom was represented repeatedly in the morbidity data table. Genitourinary toxicity consisted of 10% transient Grade 2 urinary frequency or urgency and 3% Grade 3 episode of urinary retention. Gastrointestinal toxicity was <1%.
Conclusions: High disease control rates and low morbidity demonstrate that HDR monotherapy is safe and effective for patients with localized prostate cancer.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ijrobp.2010.10.015 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Objectives: This study aimed to assess postoperative decision regret (DR) after precision prostatectomy (PP), a novel subtotal surgical technique for prostate cancer (PCa) that involves the preservation of the unilateral capsule and seminal vesicle, and to identify factors predictive of DR after PP.
Materials And Methods: After a shared decision-making process, 128 patients underwent PP for the treatment of localised PCa. Given the subtotal nature of the surgery, patients were informed about the possibility of a detectable prostate-specific antigen and secondary treatment.
Objective: Transrectal (TR) prostate biopsy is being increasingly abandoned in favour of a transperineal (TP) approach as well as a targeted biopsy only of the index lesion(s). It remains underreported how these changes could impact concordance at final pathology. We aimed to evaluate the impact of transitioning from standard transrectal (sTR) to cognitive targeted transperineal (cog-tTP) biopsy on final pathology including concordance and upgrading.
View Article and Find Full Text PDFPARP inhibitor-based treatment in metastatic, castration-resistant prostate cancer (mCRPC): A systematic review and meta-analysis.
BJUI Compass
January 2025
Division of Medical Oncology A Policlinico Umberto I Rome Italy.
Background: We present a systematic review and meta-analysis of randomized clinical trials (RCTs) with PARPi either as monotherapy or in combination with an androgen receptor-targeted agent (ARTA) in first- and second-line settings.
Methods: Primary endpoints are radiographic progression free survival (rPFS) and overall survival (OS) in patients with mCRPC and either unselected, homologous recombination repair wild-type (HRR-), homologous recombination repair mutated (HRR+) or with BRCA1, BRCA2, or ATM mutation. The effect of PARPi + ARTA in the second-line setting is also explored.
Clinical validation of a biopsy-based six-gene signature prognostic for aggressive prostate cancer.
BJUI Compass
January 2025
OncoAssure Ltd, NovaUCD Dublin Ireland.
Objectives: This study aimed to clinically validate the six-gene prognostic molecular clinical risk score (MCRS) for the prediction of aggressive prostate cancer in diagnostic biopsy tissue.
Methods: MCRS was evaluated in prostate biopsy tissue from a Swedish cohort of men with prostate cancer (UPCA, = 100). The primary outcome of adverse pathology and secondary outcomes of high primary Gleason (≥G4) and high pathological T-stage (≥T3) were assessed by likelihood ratio statistics and area under the receiver operating characteristic curves from logistic regression models; time to biochemical recurrence was assessed by likelihood ratio statistics and C-indexes from Cox proportional hazard regression models.
Objectives: To understand whether bladder outflow obstruction influences the association between traditional clinical predictive factors, particularly prostate-specific antigen (PSA) density and clinically significant prostate cancer (csPCa). This will help facilitate effective and evidence-based triaging of patients in rapid-access clinics.
Materials And Methods: We retrospectively analysed prospectively collected data from 307 suspected prostate cancer patients who underwent diagnostic biopsy from 2019 to 2023 at a single, high-volume, specialist cancer centre.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!