Combined brachytherapy and ultra-hypofractionated radiotherapy for intermediate-risk prostate cancer: Comparison of toxicity outcomes using a high-dose-rate (HDR) versus low-dose-rate (LDR) brachytherapy boost Journal Article
| Authors: | Kollmeier, M. A.; Gorovets, D.; Flynn, J.; McBride, S.; Brennan, V.; Beaudry, J.; Cohen, G.; Damato, A.; Zhang, Z.; Zelefsky, M. J. |
| Article Title: | Combined brachytherapy and ultra-hypofractionated radiotherapy for intermediate-risk prostate cancer: Comparison of toxicity outcomes using a high-dose-rate (HDR) versus low-dose-rate (LDR) brachytherapy boost |
| Abstract: | Purpose/Objective: To compare toxicity profiles of low-dose rate (LDR) and high-dose rate (HDR) brachytherapy boost combined with ultra-hypofractionated external beam radiation therapy (UH-EBRT). Materials/Methods: 99 patients with intermediate-risk prostate cancer underwent an HDR (n = 59) or LDR (n = 40) boost combined with UH-EBRT (5 Gy x 5). HDR (Ir-192) was delivered a single dose (15 Gy) and LDR (Pd-103) prescription dose was 100 Gy. Median baseline IPSS was 5 for both cohorts. Median follow-up was 29.3mos. Cumulative incidences were calculated for toxicity. Fisher exact tests were used to evaluate associations. Results: Overall incidence of grade 2 genitourinary toxicity for the entire cohort at 12 and 24 months was 21% and 29%, respectively. The incidence of grade 2 genitourinary toxicity at 12 and 24 months was higher for LDR cohort compared with HDR cohort (45% vs 5.1% and 55% vs 11%; p<0.001). On MVA, only treatment regimen (LDR versus HDR) was associated with grade 2+ genitourinary toxicity (p<0.001). Two patients experienced grade 2 rectal toxicity in each cohort. No grade > 3 toxicities were observed. Conclusions: Both LDR and HDR brachytherapy combined with UH-EBRT had favorable toxicity profiles, but significantly less grade 2+ genitourinary toxicity was observed in patients receiving HDR. © 2022 American Brachytherapy Society |
| Keywords: | adult; aged; major clinical study; treatment planning; cancer radiotherapy; comparative study; nuclear magnetic resonance imaging; follow up; tumor localization; computer assisted tomography; radiotherapy dosage; incidence; cohort analysis; radiation injury; prostate cancer; gleason score; prostatic neoplasms; dosimetry; prostate tumor; brachytherapy; external beam radiotherapy; radioisotope; urogenital tract disease; radioisotopes; androgen deprivation therapy; low energy radiation; antineoplastic hormone agonists and antagonists; iridium 192; palladium 103; palladium; cone beam computed tomography; cumulative incidence; rectal toxicity; intermediate risk patient; stereotactic radiotherapy; clinical outcome; prostate volume; procedures; rectum disease; genitourinary toxicity; hdr brachytherapy; Common Terminology Criteria for Adverse Events; palladium-103; international prostate symptom score; hypofractionated radiotherapy; radioactive seed; humans; human; male; article; gu toxicity; ldr brachytherapy; ultra-hypofractionated external beam radiotherapy; ultra hypofractionated radiotherapy |
| Journal Title: | Brachytherapy |
| Volume: | 21 |
| Issue: | 5 |
| ISSN: | 1538-4721 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2022-09-01 |
| Start Page: | 599 |
| End Page: | 604 |
| Language: | English |
| DOI: | 10.1016/j.brachy.2022.04.006 |
| PUBMED: | 35725549 |
| PROVIDER: | scopus |
| PMCID: | PMC10372465 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 October 2022 -- Source: Scopus |
