Potharaju Mahadev, Subramanaiam Ravishankar, Venkataraman Murali, Perumal Karthikeyan, Ramakrishnan Balasubramaniam, Vangara Ramakrishna, Reddy Sathiya
Department of Radiation Oncology, Apollo Hospitals.
Department of Uro-Oncology, Apollo Hospitals.
Cureus. 2015 Aug 14;7(8):e303. doi: 10.7759/cureus.303.
To report the clinical outcome after a single implant, high dose rate (HDR) brachytherapy in early prostate cancer.
All clinically localized prostate cancer patients who underwent high-dose rate (HDR) brachytherapy as monotherapy (no external beam radiotherapy) from February 2006 to September 2011 were analyzed prospectively. Acute and chronic toxicity were assessed as per Common Terminology Criteria for Adverse Events (CTCAE), Version 4.03. Biochemical recurrence was analyzed using the Kaplan Meir method. A log-rank analysis was done to compare the factors affecting the outcome.
Forty-four patients with organ-confined prostate cancer opted for HDR brachytherapy between February 2006 to September 2011 with a median follow-up of 68 months The five-year biochemical recurrence-free survival (bRFS) rate was 91%. Late Grade 2 genitourinary (GU) toxicity was observed in 9% of patients. The predictors of late Grade 2 GU toxicity were urethra V125 ≥ 0.2 cc (urethral volume receiving ≥ 125% of the prescribed dose) and PTV 150 ≥ 35% ( planning target volume receiving ≥ 150% of the prescribed dose) with p-value = 0.001 and 0.002, respectively. Erectile function was preserved in 72% of the patients who had Grade 0-1 erectile dysfunction before brachytherapy.
HDR brachytherapy in early prostate cancer results in high local control rates with minimal side-effects.
报告早期前列腺癌单次植入高剂量率（HDR）近距离放射治疗后的临床结果。
对2006年2月至2011年9月期间接受高剂量率（HDR）近距离放射治疗作为单一疗法（无外照射放疗）的所有临床局限性前列腺癌患者进行前瞻性分析。根据不良事件通用术语标准（CTCAE）第4.03版评估急性和慢性毒性。使用Kaplan-Meir方法分析生化复发情况。进行对数秩分析以比较影响结果的因素。
2006年2月至2011年9月期间，44例器官局限性前列腺癌患者选择了HDR近距离放射治疗，中位随访时间为68个月。五年生化无复发生存率（bRFS）为91%。9%的患者出现2级晚期泌尿生殖系统（GU）毒性。2级晚期GU毒性的预测因素是尿道V125≥0.2 cc（接受≥规定剂量125%的尿道体积）和PTV 150≥35%（接受≥规定剂量150%的计划靶体积），p值分别为0.001和0.002。近距离放射治疗前勃起功能为0-1级的患者中，72%的患者勃起功能得以保留。
早期前列腺癌的HDR近距离放射治疗可实现高局部控制率，且副作用最小。
