HIGH DOSE RATE BRACHYTHERAPY AS MONOTHERAPY FOR PROSTATE CANCER: FIVE YEAR RESULTS
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Keywords

PROSTATE CANCER
HIGH-DOSE RATE BRACHYTHERAPY
RADIATION TOXICITY
SURVIVAL

How to Cite

Gafton, G., Novikov, R., Novikov, S., Gotovchikova, M., Ilin, N., Girshovich, M., Kanaev, S., Melnik, Y., & Merezhko, Y. (2020). HIGH DOSE RATE BRACHYTHERAPY AS MONOTHERAPY FOR PROSTATE CANCER: FIVE YEAR RESULTS. Voprosy Onkologii, 66(4), 404–412. https://doi.org/10.37469/0507-3758-2020-66-4-404-412

Abstract

Purpose: the aim of the study is to assess the effectiveness and safety of prostate cancer treatment (PCa) with high dose rate brachytherapy (BT-HDR) in monotherapy on 5 years of follow-up. Materials and methods: BT-HDR is performed in 198 patients of PCa. The fractionation schedule was presented by two options: two fractionations of 13 Gy in the first group (67 people) and three fractionations of 11.5 Gy in the second (131 patients). The treatment was carried out with 192Ir (Microselectron). Results: the median for patient care was: I group - 59.2 (41.4-90.3), II - 56.1 (39.4-86.4) months. During the follow-up, no patients died from the progression of the PCa. The three-year survival rate without biochemical progression was 98.5%, while the second group had 92.8%; 88.8% and 88.1%, respectively. There were no significant differences in survival rates between the BT-HDR fractionation regimes compared. In most cases, late genito-urinary radiation toxicity was represented by changes that could be characterized as 1st degree. A total of 161 patients with a three-year follow-up period had three cases (1.8%) radiation-induced stenosis urethra (complications of 3 degrees): two of them in the first group, one in the second group. Only one patient (I group) (1.5%) recorded late recto-intestinal toxicity of the 2nd degree. There were no third or higher violations in the observed groups. Conclusions: the studied mono-modes of fractionation of BT- HDR PCa (two factions of 13 Gy and three factions of 11.5 Gy) demonstrated quite acceptable indicators of effectiveness and safety with a five-year period of observation. It has been established that there are no significant differences in the frequency of biochemical relapses, as well as the severity of early and late radiation toxicity in the groups compared.

https://doi.org/10.37469/0507-3758-2020-66-4-404-412
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References

Hamdy F.C., Donovan J.L., Lane J.A. et al. 10-Year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer // N. Engl. J. Med. - 2016. - Vol. 375 (15). - Р. 1415-1424.

Salomon L., Droupy S., Yiou R., Soulie M. The longterm effect of radical prostatectomy on erectile function, urinary continence, and lower urinary tract symptoms: a comparison to age-matched healthy controls // Biomed. Res. Int. - 2017. - DOI: 10.1155/2017/9615080

Heesakkers J., Farag F., Bauer R.M. et al. Pathophysiology and contributing factors in postprostatectomy incontinence: a review // Eur. Urol. - 2017. - Vol. 71 (6). - Р 936-44.

Barocas D.A., Alvarez J., Resnick M.J. et al. Association between radiation therapy, surgery, or observation for localized prostate cancer and patient-reported outcomes after 3 years // J.A.M.A. - 2017. - Vol. 317 (11). - P. 1126-40.

Chen R.C., Basak R., Meyer A.M. et al. Association between choice of radical prostatectomy, external beam radiotherapy, brachytherapy, or active surveillance and patient-reported quality of life among men with localized prostate cancer // J.A.M.A. - 2017. - Vol. 317 (11). - P. 1141-1150.

Viani G.A., Stefano E.J., Afonso S.L. Higher-than-conventional radiation doses in localized prostate cancer treatment: a meta-analysis of randomized, controlled trials // Int. J. Radiat. Oncol. Biol. Phys. - 2009. - Vol. 74 (5). - P. 1405-1418.

Mottet N., van den Bergh R.C.N., Briers E. et al. EAU Guidelines. https:// uroweb.org/guidelines/2019.

Brenner D.J., Hall E.J. Fractionation and protraction for radiotherapy of prostate carcinoma // Int. J. Radiat. Oncol. Biol. Phys. - 1999. - Vol. 43 (5). - P. 10951101.

Miralbell R., Roberts S.A., Zubizarreta E., Hendry J.H. Dose-fractionation sensitivity of prostate cancer deduced from radiotherapy outcomes of 5,969 patients in seven international institutional datasets: / =1.4 (0.9-2.2) Gy // Int. J. Radiat. Oncol. Biol. Phys. - 2012. - Vol. 82 (1). - P. 17-24.

Datta N.R., Stutz E., Rogers S., Bodis S. Clinical estimation of / values for prostate cancer from isoeffective phase III randomized trials with moderately hypofractionated radiotherapy // Acta. Oncol. - 2018. - Vol. 57 (7). - P. 883-894.

Vogelius I.R., Bentzen S.M. Dose response and fractionation sensitivity of prostate cancer after external beam radiation therapy: a meta-analysis of randomized trials // Int. J. Radiat. Oncol. Biol. Phys. - 2018. - Vol. 100 (4). - P. 858-865.

Yoshioka Y 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, T. Nose, K. Yoshida et al. // Int. J. Radiat. Oncol. Biol. Phys. - 2000. - Vol. 48 (3). - Р. 675-681.

Новиков С.Н., Канаев С.В., Новиков Р.В. и др. Высо-кодозная брахитерапия рака предстательной железы в режиме реального времени с использованием источника 192-Ir (особенности дозиметрического планирования) // Вопросы онкологии. - 2015. - Т.61 (1). - С. 130-136.

Новиков Р.В. Дозиметрическое планирование брахитерапии источником высокой мощности дозы при раке предстательной железы, с минимальной лучевой нагрузкой на уретру // Медицинская физика. - 2019. - № 2. - С. 22-8.

Withers H.R., Thames Jr H.D., Peters L.J. A new isoeffect curve for change in dose per fraction // Radiother. Oncol. - 1983. - Vol. 1. - № 2. - P. 187-191.

Joiner M.C., van der Kogel A.J. The application of the linear-quadratic dose-effect equation to fractionated and protracted. - London, UK: Arnold, 1997. - P. 106-122.

Rosen R.C., Cappelleri J.C., Smith M.D. et al. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction // Int. J. Impot. Res. - 1999. - Vol. 11 (6). - Р. 319-326.

Mohler J., Bahnson R.R., Boston B. et al. NCCN clinical practice guidelines in oncology: prostate cancer // J. Natl. Compr. Canc. Netw. - 2010. - Vol. 8. - № 2. - Р. 162-200.

3rd Roach M., Hanks G., Jr. Thames H. et al. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference // Int. J. Radiat. Oncol. Biol. Phys. - 2006. - Vol. 65 (4). - Р. 965-974.

Yoshida K., Yamazaki H., Nakamara S. et al. Comparison of common terminology criteria for adverse events v3.0 and radiation therapy oncology group toxicity score system after high-dose-rate interstitial brachytherapy as monotherapy for prostate cancer // Anticancer Res. - 2014. - Vol. 34 (4). - P. 2015-2018.

Новиков С.Н., Канаев С.В., Новиков Р.В. и др. Клинический опыт использования брахитерапии источниками высокой мощности дозы для монотерапии больных раком предстательной железы // Вопросы онкологии. - 2018. - № 3. - С. 366-373.

Tselis N., Hoskin P., Baltas D. et al. High dose rate brachytherapy as monotherapy for localised prostate cancer: review of the current status // Clin. Oncol. (R Coll Radiol). - 2017. - DOI: 10.1016/j.clon.2017.02.015

Каприн А.Д., Бирюков В.А., Карякин О.Б. и др. Применение высокомощностной брахитерапии Ir-192 в лечении рака предстательной железы // РМЖ. - 2017. - Т. 8. - С. 492-495.

Ионкова Ю.Ю., Хурцев К.В., Селютина И.А. и др. Первые результаты применения HDR-брахитерапии в лечении пациентов с опухолями предстательной железы в ГБУЗ СК "Ставропольский краевой клинический онкологический диспансер" // Экспериментальная и клиническая урология. - 2017. - № 4. - С. 117.

Солодкий В.А., Павлов А.Ю., Цыбульский А.Д. и др. Результаты применения брахитерапии высокой мощности дозы источником Ir198 в сочетании с дистанционной радиотерапией у больных раком предстательной железы с инвазией в семенные пузырьки // Эксп. и клин. урология. - 2016. - № 3. - С. 26-30.

Солодкий В.А., Павлов А.Ю., Цыбульский А.Д., Ивашин А.К. Брахитерапия источниками низкой и высокой мощности дозы в комбинации с дистанционной радиотерапией в лечение больных раком предстательной железы средней и высокой групп риска прогрессирования // Вопросы онкологии. - 2018. - № 1. - С. 79-83.

Yoshioka Y, Nose T., Yoshida K. 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. Radiat. Oncol. Biol. Phys. - 2000. - Vol. 48 (3). - Р. 675-681.

Hathout L., Mahmoud O., Wang Y et al. A phase 2 randomized pilot study comparing high-dose-rate brachytherapy and low-dose-rate brachytherapy as monotherapy in localized prostate cancer // Adv. Radiat. Oncol. - 2019. - Vol. 4 (4). - P. 631-640.

Barnes J.M., Gabani P., Sanders M. et al. Single fraction high-dose-rate brachytherapy as monotherapy for low and intermediate risk prostate cancer: toxicities and early outcomes from a single institutional experience // J. Contemp. Brachytherapy. - 2019. - Vol. 11 (5). - P. 399-408.

Siddiqui Z.A., Gustafson G.S., Ye H. et al. 5-year outcomes of a single institution prospective trial of 19 gy singlefraction HDR brachytherapy for low- and intermediate-risk prostate cancer // Int. J. Radiat. Oncol. Biol. Phys. - 2019. - Vol. 104 (5). - P. 1038-1044.

Новиков С.Н., Канаев С.В., Баянкин С.Н. и др. Рекомендации по лечению рака предстательной железы с помощью высокомощностной внутритканевой лучевой терапии (брахитерапии) Экспертное совещание, 17 ноября 2016, Москва // Экспериментальная и клиническая урология. - 2017. - № 3. - С. 10-23.

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