High-dose-rate interstitial brachytherapy as a monotherapy for localized prostate cancer: Treatment description and preliminary results of a phase I/II clinical trial
Y. Yoshioka et al., High-dose-rate interstitial brachytherapy as a monotherapy for localized prostate cancer: Treatment description and preliminary results of a phase I/II clinical trial, INT J RAD O, 48(3), 2000, pp. 675-681
Citations number
13
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Onconogenesis & Cancer Research
Journal title
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
Purpose: To improve results for localized prostate cancer, a prospective cl
inical trial of hyperfractionated Iridium-192 high-dose-rate (HDR) brachyth
erapy as a monotherapy was initiated.
Methods and Materials: Between May 1995 and September 1998, 22 implants wer
e performed on 22 patients with localized prostate cancer (T1:T2:T3:T4 = 4:
6:9:3) at Osaka University Hospital. Nineteen patients, who had T3-T4 tumor
s or pretreatment PSA greater than or equal to 20.0 ng/mL, received hormone
therapy. No patient had external beam radiation. Transperineal needle impl
ants using real-time ultrasound guidance were performed, followed by dose o
ptimization program. Patients were irradiated twice a day, with a time inte
rval of more than 6 h. Total dose was 48 Gy/8 fractions/5 days or 54 Gy/9 f
ractions/5 days. Acute toxicity was scored using the Radiation Therapy Onco
logy Group (RTOG) radiation morbidity scoring criteria. Median follow-up ti
me was 31 months.
Results: HDR brachytherapy as a monotherapy was well-tolerated. No signific
ant intra- or peri-operative complications occurred. No patient experienced
acute toxicity of grade 3 or more. PSA levels normalized in 95% of patient
s within 20 months after irradiation. Four-year clinical and biochemical re
lapse-free rates were 95% and 55%, respectively.
Conclusion: Acute toxicity with this method was acceptable. Further patient
accrual and longer follow-up will allow comparison to other techniques. (C
) 2000 Elsevier Science Inc.