Dosimetric coverage of the prostate, normal tissue sparing, and acute toxicity with high-dose-rate brachytherapy for large prostate volumes

To evaluate dosimetric coverage of the prostate, normal tissue sparing, and acute toxicity with HDR brachytherapy for large prostate volumes.

One hundred and two prostate cancer patients with prostate volumes >50 mL (range: 5-29 mL) were treated with high-dose-rate (HDR) brachytherapy ± intensity modulated radiation therapy (IMRT) to 4,500 cGy in 25 daily fractions between 2009 and 2013.

HDR brachytherapy monotherapy doses consisted of two 1,350-1,400 cGy fractions separated by 2-3 weeks, and HDR brachytherapy boost doses consisted of two 950-1,150 cGy fractions separated by 4 weeks Twelve of 32 (38%) unfavorable intermediate risk, high risk, and very high risk patients received androgen deprivation therapy Acute toxicity was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4

Median follow-up was 14 months Dosimetric goals were achieved in over 90% of cases Three of 102 (3%) patients developed Grade 2 acute proctitis No variables were significantly associated with Grade 2 acute proctitis Seventeen of 102 (17%) patients developed Grade 2 acute urinary retention American Urological Association (AUA) symptom score was the only variable significantly associated with Grade 2 acute urinary retention (p=0 04) There was no ≥ Grade 3 acute toxicity

Dosimetric coverage of the prostate and normal tissue sparing were adequate in patients with prostate volumes >50 mL Higher pre-treatment AUA symptom scores increased the relative risk of Grade 2 acute urinary retention However, the overall incidence of acute toxicity was acceptable in patients with large prostate volumes

International braz j urol : official journal of the Brazilian Society of Urology 0000 [Epub]

George Yang, Tobin J Strom, Richard B Wilder, Kushagra Shrinath, Eric A Mellon, Daniel C Fernandez, Matthew C Biagioli

Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA , Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA , Cancer Treatment Centers of America, Newnan, GA 30265, USA , Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA , Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA , Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA , Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA

PubMed   

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