Department of Radiation Oncology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
Department of Radiotherapy and Oncology, J. W. Goethe University of Frankfurt, Frankfurt am Main, Germany.
Radiother Oncol. 2018 Feb;126(2):270-277. doi: 10.1016/j.radonc.2017.09.038. Epub 2017 Oct 23.
To evaluate the oncological outcome of a three-implant high dose rate (HDR) brachytherapy (BRT) protocol as monotherapy for clinically localised prostate cancer.
Between February 2008 and December 2012, 450 consecutive patients with clinically localised prostate cancer were treated with HDR monotherapy. The cohort comprised of 198 low-, 135 intermediate- and 117 high risk patients being treated with three single-fraction implants of 11.5Gy delivered to an intraoperative real-time, transrectal ultrasound defined planning treatment volume up to a total physical dose of 34.5Gy with an interfractional interval of 21days. Fifty-eight patients (12.8%) received ADT, 32 of whom were high- and 26 intermediate-risk. Biochemical failure was defined according to the Phoenix Consensus Criteria and genitourinary/gastrointestinal toxicity evaluated using the Common Toxicity Criteria for Adverse Events version 3.0.
The median follow-up time was 56.3months. The 60-month overall survival, biochemical control and metastasis-free-survival rates were 96.2%, 95.0% and 99.0%, respectively. Toxicity was scored per event with late Grade 2 and 3 genitourinary adverse events of 14.2% and 0.8%, respectively. Late Grade 2 gastrointestinal toxicity amounted 0.4% with no instances of Grade 3 or greater late adverse events to be reported.
Our results confirm HDR BRT to be a safe and effective monotherapeutic treatment modality for clinically localised prostate cancer.
评估三种植入物高剂量率（HDR）近距离放疗（BRT）作为单一疗法治疗局限性前列腺癌的肿瘤学结果。
2008 年 2 月至 2012 年 12 月，450 例局限性前列腺癌患者接受 HDR 单一疗法治疗。该队列包括 198 例低危、135 例中危和 117 例高危患者，采用三次单剂量植入物（11.5Gy）治疗，在 21 天的间隔内，将单次剂量的 34.5Gy 递送至术中实时经直肠超声定义的计划治疗体积。58 例（12.8%）患者接受 ADT，其中 32 例为高危，26 例为中危。生化失败根据凤凰共识标准定义，使用不良反应事件通用毒性标准 3.0 评估泌尿生殖系统/胃肠道毒性。
中位随访时间为 56.3 个月。60 个月的总生存率、生化控制率和无转移生存率分别为 96.2%、95.0%和 99.0%。根据事件评分毒性，晚期 2 级和 3 级泌尿生殖系统不良事件发生率分别为 14.2%和 0.8%。晚期 2 级胃肠道毒性发生率为 0.4%，无 3 级或更高级别的晚期不良事件报告。
我们的结果证实 HDR BRT 是一种安全有效的单一疗法治疗局限性前列腺癌。
