Single Fraction High-Dose-Rate Brachytherapy: Too Good to Be True?
Permanent seed prostate brachytherapy as monotherapy is a highly effective treatment option for men with low- and intermediate-risk prostate cancer, with long-term cancer control rates of 90% or higher. It has the convenience of a single treatment but often results in moderate urinary tract symptoms over a few months while the radiation is being delivered. Furthermore, seed loss or displacement can lead to suboptimal dosimetry, including cold areas within the prostate and higher dose than intended to urethra, rectum, and bladder.
ConclusionThe single-fraction HDR-BT with EBRT is a safe treatment for quicker recovery of urinary symptoms and QOL. The dose of at-risk organs correlated with toxicities.Secondary abstractSingle-fraction high-dose-rate brachytherapy (HDR-BT) combined with external beam radiotherapy (EBRT) for prostate cancer is a safe treatment allowing for quicker recovery of urinary symptoms and QOL. The dose of at-risk organs correlated with toxicities.
Conclusions: Based on our biological dose summation method, the total dose of prostate is higher using BT boost than the IMAT. BT boost yields lower rectum, bladder, and hips doses, but higher dose to urethra. UDC overestimates rectum and bladder dose and underestimates the dose to urethra. PMID: 32695198 [PubMed]
awa M Abstract Interventional therapies are emerging modalities for the treatment of localized prostate cancer. Their aim is to reduce the morbidity associated with radical therapies (rT) by minimizing damage to non-cancerous tissue, with priority given to sparing key structures such as the neurovascular bundles, external sphincter, bladder neck, and rectum, while maintaining local cancer control. Interventional ablative technologies deliver energy in different ways to destroy cancer cells. The most widely investigated techniques are brachytherapy, external beam radiotherapy, cryotherapy, and high-intensity focuse...
Conclusions: Higher dose volumes for the bladder and rectum predicted for poorer PR-QOL. In contrast to prostate brachytherapy data, neither prostate volume nor urethral dosimetry at this dose schedule correlated with urinary symptoms.
CONCLUSIONS: Higher dose volumes for the bladder and rectum predicted for poorer PR-QOL. In contrast to prostate brachytherapy data, neither prostate volume nor urethral dosimetry at this dose schedule correlated with urinary symptoms. PMID: 31584457 [PubMed - as supplied by publisher]
Conclusions: Insertion of HS in prostate cancer patients receiving combined HDR and EBRT is safe and has resulted in a significant radiation dose reduction to the rectum, resulting in significantly less acute GI toxicity and a trend towards less late GI toxicity. PMID: 30911304 [PubMed]
CONCLUSIONS: Second focal salvage MRI-guided HDR-BT for a select group of patients with a second locally recurrent prostate cancer is feasible. There was no grade 3 or more acute toxicity for these four patients. PMID: 28533806 [PubMed - in process]
CONCLUSION: With a mean follow-up of more than 11 years, this series does not detect any excess risk of second cancers associated with permanent implant prostate brachytherapy. However, due to power limitation, a small increase in the risk of secondary malignancies cannot be totally ruled out. PMID: 28499661 [PubMed - as supplied by publisher]
Abstract MR-guided high-dose-rate (HDR) brachytherapy has gained increasing interest as a treatment for patients with localized prostate cancer because of the superior value of MRI for tumor and surrounding tissues localization. To enable needle insertion into the prostate with the patient in the MR bore, a single needle MR-compatible robotic system involving needle-by-needle dose delivery has been developed at our institution. Throughout the intervention, dose delivery may be impaired by: (1) sub-optimal needle positioning caused by e.g. needle bending, (2) intra-operative internal organ motion such as prostate r...
CONCLUSIONS: Salvage brachytherapy for localized prostate cancer (3 × 10 Gy every 14 days) seems to be a safe and well tolerated procedure. A significant decline in prostate-specific antigen (PSA) level is seen in patients with hormone-responsive cancer. Long-term efficiency and toxicity of the procedure are yet to be established. PMID: 28050174 [PubMed]