Abstract
Introduction: To examine the long-term outcomes of high dose rate brachytherapy boost (HDR-BT) combined with external beam radiotherapy (EBRT) for intermediate and high-risk prostate cancer patients. Methods: Data from 95 patients who underwent combined EBRT (50.4 Gy) and HDR-BT to the prostate between 2010 and 2017 were retrospectively analysed. Biochemical progression free survival (bPFS), local recurrence free survival (LRFS), metastatic free survival (MFS) and overall survival (OS) were estimated using Kaplan–Meier method. Regression analysis was conducted to identify important predictors of outcomes. Results: A total of 24 patients received an initial HDR-BT dose of 18 Gy in three fractions, with the remaining 71 patients receiving 16 Gy in two fractions as per departmental protocol changes. Most patients (88%) received androgen deprivation therapy. A transurethral resection of the prostate (TURP) was performed in 14 patients and hydrogel spacers (HS) were used in 30 patients. Median follow-up was 58 months. The 5-year bPFS, LRFS, MFS and OS were 92%, 100%, 92% and 88%. Univariate regression revealed no statistical association between patient characteristics and time to relapse (all P > 0.1). Late > grade 2 genitourinary (GU) toxicity was 6.3%. The use of HS or prior TURP had no impact on late GU toxicity. Late Grade 1 gastrointestinal (GI) toxicity was 5.3%. Conclusion: The combined HDR-BT with EBRT resulted in excellent bPFS. The cumulative risk of late GU and GI toxicity was low and can be further improved with preventative strategies such as a pre-emptive TURP and/or HS insertion.
| Original language | English |
|---|---|
| Pages (from-to) | 415–421 |
| Number of pages | 7 |
| Journal | Journal of Medical Imaging and Radiation Oncology |
| Volume | 63 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Jun 2019 |
Keywords
- HDR brachytherapy
- hydrogel spacers
- prostate
- TURP
Cite this
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High dose rate brachytherapy boost for prostate cancer : Biochemical control and the impact of transurethral resection of the prostate and hydrogel spacer insertion on toxicity outcomes. / Chao, Michael; Bolton, Damien; Lim Joon, Daryl; Chan, Yee; Lawrentschuk, Nathan; Ho, Huong; Spencer, Sandra; Wasiak, Jason; Guerrieri, Mario; Ow, Darren; Troy, Andrew; Pham, Trung; Sengupta, Shomik; Tan, Alwin; McMillan, Kevin; Koufogiannis, George; Foroudi, Farshad; Ng, Michael; Khoo, Vincent.
In: Journal of Medical Imaging and Radiation Oncology, Vol. 63, No. 3, 06.2019, p. 415–421.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - High dose rate brachytherapy boost for prostate cancer
T2 - Biochemical control and the impact of transurethral resection of the prostate and hydrogel spacer insertion on toxicity outcomes
AU - Chao, Michael
AU - Bolton, Damien
AU - Lim Joon, Daryl
AU - Chan, Yee
AU - Lawrentschuk, Nathan
AU - Ho, Huong
AU - Spencer, Sandra
AU - Wasiak, Jason
AU - Guerrieri, Mario
AU - Ow, Darren
AU - Troy, Andrew
AU - Pham, Trung
AU - Sengupta, Shomik
AU - Tan, Alwin
AU - McMillan, Kevin
AU - Koufogiannis, George
AU - Foroudi, Farshad
AU - Ng, Michael
AU - Khoo, Vincent
PY - 2019/6
Y1 - 2019/6
N2 - Introduction: To examine the long-term outcomes of high dose rate brachytherapy boost (HDR-BT) combined with external beam radiotherapy (EBRT) for intermediate and high-risk prostate cancer patients. Methods: Data from 95 patients who underwent combined EBRT (50.4 Gy) and HDR-BT to the prostate between 2010 and 2017 were retrospectively analysed. Biochemical progression free survival (bPFS), local recurrence free survival (LRFS), metastatic free survival (MFS) and overall survival (OS) were estimated using Kaplan–Meier method. Regression analysis was conducted to identify important predictors of outcomes. Results: A total of 24 patients received an initial HDR-BT dose of 18 Gy in three fractions, with the remaining 71 patients receiving 16 Gy in two fractions as per departmental protocol changes. Most patients (88%) received androgen deprivation therapy. A transurethral resection of the prostate (TURP) was performed in 14 patients and hydrogel spacers (HS) were used in 30 patients. Median follow-up was 58 months. The 5-year bPFS, LRFS, MFS and OS were 92%, 100%, 92% and 88%. Univariate regression revealed no statistical association between patient characteristics and time to relapse (all P > 0.1). Late > grade 2 genitourinary (GU) toxicity was 6.3%. The use of HS or prior TURP had no impact on late GU toxicity. Late Grade 1 gastrointestinal (GI) toxicity was 5.3%. Conclusion: The combined HDR-BT with EBRT resulted in excellent bPFS. The cumulative risk of late GU and GI toxicity was low and can be further improved with preventative strategies such as a pre-emptive TURP and/or HS insertion.
AB - Introduction: To examine the long-term outcomes of high dose rate brachytherapy boost (HDR-BT) combined with external beam radiotherapy (EBRT) for intermediate and high-risk prostate cancer patients. Methods: Data from 95 patients who underwent combined EBRT (50.4 Gy) and HDR-BT to the prostate between 2010 and 2017 were retrospectively analysed. Biochemical progression free survival (bPFS), local recurrence free survival (LRFS), metastatic free survival (MFS) and overall survival (OS) were estimated using Kaplan–Meier method. Regression analysis was conducted to identify important predictors of outcomes. Results: A total of 24 patients received an initial HDR-BT dose of 18 Gy in three fractions, with the remaining 71 patients receiving 16 Gy in two fractions as per departmental protocol changes. Most patients (88%) received androgen deprivation therapy. A transurethral resection of the prostate (TURP) was performed in 14 patients and hydrogel spacers (HS) were used in 30 patients. Median follow-up was 58 months. The 5-year bPFS, LRFS, MFS and OS were 92%, 100%, 92% and 88%. Univariate regression revealed no statistical association between patient characteristics and time to relapse (all P > 0.1). Late > grade 2 genitourinary (GU) toxicity was 6.3%. The use of HS or prior TURP had no impact on late GU toxicity. Late Grade 1 gastrointestinal (GI) toxicity was 5.3%. Conclusion: The combined HDR-BT with EBRT resulted in excellent bPFS. The cumulative risk of late GU and GI toxicity was low and can be further improved with preventative strategies such as a pre-emptive TURP and/or HS insertion.
KW - HDR brachytherapy
KW - hydrogel spacers
KW - prostate
KW - TURP
UR - http://www.scopus.com/inward/record.url?scp=85063372549&partnerID=8YFLogxK
U2 - 10.1111/1754-9485.12882
DO - 10.1111/1754-9485.12882
M3 - Article
C2 - 30908894
AN - SCOPUS:85063372549
VL - 63
SP - 415
EP - 421
JO - Journal of Medical Imaging and Radiation Oncology
JF - Journal of Medical Imaging and Radiation Oncology
SN - 1754-9477
IS - 3
ER -