Focal salvage iodine-125 brachytherapy for prostate cancer recurrences after primary radiotherapy: A retrospective study regarding toxicity, biochemical outcome and quality of life
Focal salvage iodine-125 brachytherapy for prostate cancer recurrences after primary radiotherapy: A retrospective study regarding toxicity, biochemical outcome and quality of life
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DOI：
10.1016/j.radonc.2014.06.013
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发表时间：
2014-07-01
影响因子：
5.7
通讯作者：
van Vulpen, Marco
中科院分区：
文献类型：
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作者：
Peters, Max;Maenhout, Metha;van Vulpen, Marco
目的：复发性前列腺癌（PCa）的全腺体保留治疗失败率和毒性反应率较高。早期和适当的局部复发，使局灶性挽救，从而有可能提高功能的结果，同时保持cancercontrol.Materials和方法：回顾性分析产生了20个局灶性挽救1125局部复发PCa后，主要放疗近距离放射治疗患者。通过多参数MRI和经直肠活检确定肿瘤。术中获得剂量数据。肿瘤处方>= 144戈伊。根据不良事件通用术语标准第4版（CTCAE-4）对毒性进行评分。使用Phoenix标准（PSA最低值+2.0 ng/ml）定义生化失败（BF）。生活质量（QoL）测量SF-36健康调查和欧洲癌症研究和治疗组织（EORTC）C30+3和PR 25 questionnaires.Results：中位随访36个月（范围10-45），6例患者发生BF，其中3例无初始反应。1例患者发生3级泌尿生殖系统（GU）毒性（尿道狭窄）。五名先前有勃起功能的患者保留了勃起功能。结论：局灶挽救性1125近距离放射治疗20例患者中出现3级GU毒性。生化反应和生活质量可接受。(C)2014爱思唯尔爱尔兰有限公司版权所有。
Purpose: Whole-gland salvage for recurrent prostate cancer (PCa) shows high failure and toxicity rates. Early and adequate localization of recurrences enables focal salvage, thereby potentially improving functional outcomes, while maintaining cancer control.Materials and methods: Retrospective analysis yielded 20 focal salvage 1125 brachytherapy patients for locally recurrent PCa after primary radiotherapy. Tumor was defined by multiparametric MRI and correspondence with transrectal biopsies. Dose data were obtained intra-operatively. The tumor was prescribed >= 144 Gy. Toxicity was scored by the Common Terminology Criteria for Adverse Events version 4 (CTCAE-4). Biochemical failure (BF) was defined using the Phoenix criteria (PSA-nadir + 2.0 ng/ml). Quality of life (QoL) was measured by SF-36 Health Survey and European Organization of Research and Treatment of Cancer (EORTC) C30+3 and PR25 questionnaires.Results: With a median follow-up of 36 months (range 10-45), six patients experienced BF, of which three had no initial response. Grade 3 genitourinary (GU) toxicity occurred in one patient (a urethral stricture). The five previously potent patients retained erectile function. QoL remained decreased with regard to urinary symptoms.Conclusion: Focal salvage 1125 brachytherapy showed one grade 3 GU toxicity in the 20 treated patients. Biochemical response and QoL were acceptable. (C) 2014 Elsevier Ireland Ltd. All rights reserved.