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