Fractionated high-dose-rate brachytherapy as monotherapy in prostate cancer: Does implant displacement and its correction influence acute and late toxicity?

In fractionated high-dose-rate brachytherapy (HDR-BT) for prostate cancer (PCa) with one implant for several fractions, dose delivery relies on reproducibility of catheter positions. However, caudal displacement of implanted catheters does occur between fractions and needs to be corrected. Our protocol prescribes correction of displacements > 3 mm. We investigated whether displacement and its corrections influence acute and late toxicity incidences.

We analyzed 162 PCa patients treated with HDR-BT monotherapy between 2007 and 2013. The implant remained in situ between the 4 fractions. Catheter displacement was assessed before each fraction using lateral X-ray images and corrected if needed. Genitourinary (GU) and gastrointestinal (GI) acute and late toxicities were assessed using clinical record forms and patient self-assessment questionnaires.

Implant displacement corrections (DC) were needed in 71 patients (43.8%) whereas no DCs were needed in 91 patients (56.2%). No statistically significant differences were seen in acute and late grade ≥ 2 GU and GI toxicity incidences between DC and no DC groups. The maximum displacement nor the number of corrections had any influence on toxicity.

The occurrence and subsequent correction of implant displacements exceeding 3 mm during fractionated HDR-BT monotherapy for PCa did not lead to increased incidences of acute or late GU and GI toxicity. This indicates that our clinical protocol to correct displacements > 3 mm results in safe treatment regarding organ at risk toxicity.

Brachytherapy. 2016 Jun 27 [Epub ahead of print]

Shafak Aluwini, Wendy M H Busser, Lizette E A Baartman, Anand Bhawanie, Wendimagegn G Alemayehu, Joost L Boormans, Inger-Karine K Kolkman-Deurloo

Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands. Electronic address: ., Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Clinical Trials Center, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Department of Urology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.

E-Newsletters

Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.

Subscribe