Lam Cham Kee D, Peiffert D, Hannoun-Lévi J-M
Département de radiothérapie oncologique, centre Antoine-Lacassagne, 33, avenue Valombrose, 06107 Nice cedex, France; Université Côte d'Azur, 33, avenue Valombrose, 06107 Nice cedex, France.
CS 30519, institut de cancérologie de Lorraine Alexis-Vautrin, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy cedex, France; CS 30519, université de Lorraine, 6, avenue de Bourgogne, 54519 Vandœuvre-lès-Nancy cedex, France.
Cancer Radiother. 2019 Dec;23(8):847-852. doi: 10.1016/j.canrad.2019.06.003. Epub 2019 Jul 30.
Brachytherapy can be used for the treatment of every localized prostate cancer, notably as boost for intermediate- and high-risk prostate cancer. With the incidence of prostate cancer increasing significantly during the next decades and brachytherapy developing, we conducted a descriptive survey to analyse the current status of prostate brachytherapy in France to see if the future demands could be met.
All radiotherapy centres that declared providing brachytherapy were found from the French national institute of cancer registry and they were asked to reply to an online form in April 2018.
Fifty-two of the 54-brachytherapy centres (96%) replied the form and 34 centres did prostate brachytherapy. Among those centres, 32 performed iodine 125 low-dose rate brachytherapy as monotherapy, 19 provided brachytherapy boost (eight centres low-dose rate 125I; seven centres high-dose rate; four centres both). Among the centres not performing brachytherapy boost, 18 wanted to do, eight did not want and nine did not reply. The main reasons for reluctance towards brachytherapy boost were: organization constraints (three centres), refer patients to a nearby brachytherapy centre (one centre), technical issues (two centres) and lack of strong scientific evidences (two centres). In terms of human resources, the mean number of trained physicians and physicists were two (range: 1-6) and three (range: 1-5) respectively.
In France, the future needs for prostate brachytherapy cannot be met by the current health supply. Health authorities should firstly reimburse brachytherapy boost and redefine an optimal training and organization of centres such that every patient with prostate cancer can receive optimal treatment.
近距离放射治疗可用于治疗各种局限性前列腺癌,尤其是作为中高危前列腺癌的辅助治疗。随着未来几十年前列腺癌发病率显著上升以及近距离放射治疗的发展,我们开展了一项描述性调查,以分析法国前列腺近距离放射治疗的现状,看看未来的需求能否得到满足。
从法国国家癌症登记处找出所有宣称提供近距离放射治疗的放疗中心,并要求它们在2018年4月回复一份在线表格。
54个近距离放射治疗中心中的52个(96%)回复了表格,其中34个中心进行前列腺近距离放射治疗。在这些中心中,32个中心将碘125低剂量率近距离放射治疗作为单一疗法,19个中心提供近距离放射治疗辅助(8个中心为125I低剂量率;7个中心为高剂量率;4个中心两者都有)。在不进行近距离放射治疗辅助的中心中,18个中心想要开展,8个中心不想开展,9个中心未回复。不愿开展近距离放射治疗辅助的主要原因有:组织限制(3个中心)、将患者转诊至附近的近距离放射治疗中心(1个中心)、技术问题(2个中心)以及缺乏有力的科学证据(2个中心)。在人力资源方面,经过培训的医生和物理学家的平均人数分别为2名(范围:1 - 6名)和3名(范围:1 - 5名)。
在法国,目前的医疗供应无法满足前列腺近距离放射治疗未来的需求。卫生当局应首先报销近距离放射治疗辅助费用,并重新定义中心的最佳培训和组织方式,以便每位前列腺癌患者都能接受最佳治疗。