Focal brachytherapy for selected low-risk prostate cancers: A pilot study
Focal brachytherapy for selected low-risk prostate cancers: A pilot study
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DOI：
10.1016/j.brachy.2013.02.002
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发表时间：
2013-07-01
期刊：
影响因子：
1.9
通讯作者：
Vallancien, Guy
中科院分区：
文献类型：
--
作者：
Cosset, Jean-Marc;Cathelineau, Xavier;Vallancien, Guy
目的：评价局灶性近距离放射治疗高选择性局限性前列腺癌患者的可行性及早期毒性。方法和材料：2010年2月至2012年3月期间，21例患者接受了局灶性近距离治疗，占本组同期治疗病例的3.7%。患者的选择是基于（至少）两个系列的前列腺活检和一个高分辨率的MRI。根据严格的标准，只有非常有限和局部肿瘤的患者才被选中进行手术。该技术采用实时程序，游离I-125粒子植入和动态剂量计算。病灶体积的规定剂量为145戈瑞。结果：治疗体积相当于前列腺总体积的34%（范围20-48%）。对于病灶体积，平均D-90和V-100分别为183.2 Gy（范围为176 ~ 188 Gy）和99.3%（范围为98.8 ~ 100%）。这项技术在一个半小时内完成。与先前接受全前列腺近距离放射治疗的队列相比，尿毒性（国际前列腺症状评分）仅在6个月时就临界降低（p = 0.04），而国际勃起功能指数5的恢复则更好（p = 0.014）。几乎所有病例的国际失禁评分均为零，直肠毒性也为零。结论：近距离局部治疗容易，急性毒性小。需要进一步的研究来评估肿瘤控制和长期毒性方面的结果。(C) 2013年美国近距离放射治疗学会。Elsevier Inc.出版。版权所有。
PURPOSE: To evaluate the feasibility and the early toxicity of focal brachytherapy in highly selected localized prostate cancer patients.METHODS AND MATERIALS: Twenty-one patients underwent a focal brachytherapy between February 2010 and March 2012, representing 3.7% of the cases treated by our group during this period. Patient selection was based on (at least) two series of prostate biopsies and a high-resolution MRI. Only patients with very limited and localized tumors, according to strict criteria, were selected for the procedure. The technique used a real-time procedure with the implantation of free I-125 seeds and dynamic dose calculation. The prescribed dose for the focal volume was 145 Gy.RESULTS: The treated volume corresponded to a mean value of 34% of the total prostatic volume (range, 20-48%). For the focal volume, the mean D-90 and V-100 was 183.2 Gy (range, 176-188 Gy) and 99.3% (range, 98.8-100%), respectively. The technique was performed in an hour and a half. When compared with a previous cohort treated by whole-prostate brachytherapy, urinary toxicity (International Prostate Symptom Score) was borderline reduced (p = 0.04) at 6 months only, whereas the recovery of the International Index of Erectile Function 5 was better (p = 0.014). The International Continence Score was nil in almost all cases as well as rectal toxicity.CONCLUSION: Focal treatment by brachytherapy is easily feasible with little acute toxicity. Further investigation is needed to assess the results in terms of tumor control and long-term toxicity. (C) 2013 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.