Zuber Simon, Weiß Susan, Baaske Dieter, Schöpe Michael, Stevens Simon, Bodis Stephan, Zwahlen Daniel R
Klinikum Chemnitz gGmbH, Klinik für Radio-Onkologie, Flemmingstrasse 2, D-09116, Chemnitz, Germany.
The London Clinic, 22 Devonshire Place, London, W1G 6JA, UK.
Radiat Oncol. 2015 Feb 22;10:49. doi: 10.1186/s13014-015-0349-0.
We are reporting the five-year biochemical control, toxicity profile and dosimetric parameters using iodine-125 low dose rate brachytherapy (BT) as monotherapy for early stage prostate cancer at a single institution.
Between April 2006 and December 2010, 169 men with early stage prostate cancer were treated with BT. Biochemical failure was defined using the Phoenix definition (nadir + 2 ng/mL). Treatment-related morbidities, including urinary, rectal and sexual function, were measured, applying the International Prostate Symptom Score (IPSS), the 7-grade Quality of Life Scale (QoL) and medical status, the International Consultation on Incontinence Modular Questionnaire (ICIQ), the International Index of Erectile Function (IIEF-5) and the Common Terminology Criteria for Adverse Events (CTCAE v4.03). Seed migration and loss, dosimetric parameters and learning effects were also analyzed.
Medium follow-up time was 50 months (range, 1-85 months). The five-year biochemical failure rate was 7%. Acute proctitis rates were 19% (grade 1) and 1% (grade 2), respectively. The overall incidence of incontinence was 19% (mild), 16% (moderate) and < 1% (severe). An increase in IPSS ≥ 5 points was detected in 59% of patients, with 38% regaining their baseline. Seed dislocation was found in 24% of patients and correlated with D90 and V100. A learning curve was found for seed migration, D90 and V100. QoL correlated with the general health condition of patient, incontinence symptoms and IPSS.
BT for early stage prostate cancer offers excellent five-year biochemical control with low toxicities. QoL aspects are favorable. A learning curve was detected for procedural aspects but its impact on patient relevant endpoints remains inconclusive.
我们报告了在单一机构中，使用碘-125低剂量率近距离放射治疗（BT）作为早期前列腺癌单一疗法的五年生化控制、毒性特征和剂量学参数。
2006年4月至2010年12月期间，169例早期前列腺癌男性患者接受了BT治疗。生化失败采用Phoenix定义（最低点+2 ng/mL）。使用国际前列腺症状评分（IPSS）、7级生活质量量表（QoL）和医疗状况、国际尿失禁咨询模块化问卷（ICIQ）、国际勃起功能指数（IIEF-5）和不良事件通用术语标准（CTCAE v4.03）来测量与治疗相关的发病率，包括泌尿、直肠和性功能。还分析了粒子迁移和丢失、剂量学参数及学习效应。
中位随访时间为50个月（范围1 - 85个月）。五年生化失败率为7%。急性直肠炎发生率分别为19%（1级）和1%（2级）。尿失禁的总体发生率为19%（轻度）、16%（中度）和<1%（重度）。59%的患者IPSS增加≥5分，38%的患者恢复到基线水平。24%的患者发现粒子移位，且与D90和V100相关。发现粒子迁移、D90和V100存在学习曲线。QoL与患者的总体健康状况、尿失禁症状和IPSS相关。
早期前列腺癌的BT提供了良好的五年生化控制且毒性较低。生活质量方面良好。在操作方面发现了学习曲线，但其对患者相关终点的影响仍不确定。
