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LDR I-125 brachytherapy as treatment for intracapsular prostate cancer
EAU16th Central European Meeting, 7-8 October 2016, Vienna, Austria
44
LDR I-125 brachytherapy as treatment for intracapsular prostate cancer Eur Urol Suppl 2016; 15(11);e1404
Brinzan D.M.1, Constantin T.V.2, Radu T.M.2, Ambert V.2, Braticevici B.2, Petca R.2, Rascu S.2, Badescu D.2, Kacso G.3, Jinga V.2 1
“Prof. Dr. Th. Burghele” Clinical Hospital, Dept. of Urology, Bucharest, Romania, 2Unversity of Medicine and Pharmacy Carol Davila, "Prof. Dr. Th. Burghele" Clinical Hospital, Department of Urology, Bucharest, Romania, 3Iuliu Hatieganu" University of Medicine and Pharmacy, "Prof. Dr. I. Chiricuta" Oncology Institute Radiotherapy II Department, Cluj, Romania INTRODUCTION & OBJECTIVES: Brachytherapy is considered a curative treatment option for patients diagnosed with localized prostate cancer. The current paper aims to examine Low Dose Rate I125 Brachytherapy as treatment for intracapsular prostate cancer. MATERIAL & METHODS: The studied group was composed of 80 patients diagnosed with intracapsular prostate cancer treated with LDR brachytherapy I-125 in the Radiotherapy Clinic of Oncology Institute "Al. Chiricuta " Cluj Napoca during January 2007 and June 2013. 35 of those patients where diagnosed with PC at Burghele clinical hospital and also came there for follow-up. The prevailing stage was T2a- 49 (61.3%) patients. The mean value of PSA was: 8.43ng/ml. 25 patients (31.25%) of the brachytherapy group have previously received hormonal treatment. All the patients of the group presented with an IPSS score of ≤12. The administered dose was 145 Gy. RESULTS: Postoperative clinical manifestations as well as early and late complications were monitored, developed secondary to urethral and rectal toxicity. PSA was monitored at 3, 6, 9, 12, 18, 24 months and then yearly. The survival rate at the end of the study was 92.5%. 6 deaths were registered, of which 2 were secondary to the underlying disease. Biochemical relapse was registered in 6 cases (7.5%). The PSA bounce phenomenon was encountered in 28 patients (35%). 37 patients (46.2%) developed grade I acute urinary toxicity (AUT), while 32 patients (40%) presented with AUT grade 2. In a significantly lower number of cases, AUT grade 3 symptoms were registered. Late urinary toxicity was evaluated at minimum 12 months. The most frequent grade of urinary toxicity was grade 1 – 36 patients (51.4%). 51 patients (63.75%) did not develop digestive symptoms (rectal toxicity), while in 25 cases grade 1 rectal toxicity was encountered. 2 patients presented with grade 2 rectal toxicity, while other 2 patients encountered grade 3. One year after brachytherapy seeds implantation, most of the patients 59 (84.29) did not present late rectal toxicity. 31 patients did not present any manifestations of acute sexual toxicity. In 24 cases (30%)
Eur Urol Suppl 2016; 15(11);e1404
EAU16th Central European Meeting, 7-8 October 2016, Vienna, Austria
44
LDR I-125 brachytherapy as treatment for intracapsular prostate cancer Eur Urol Suppl 2016; 15(11);e1405
grade 1 sexual toxicity was encountered and for 15 patients ( 18.75%) grade 2 sexual toxicity was encountered, while for 10 patients, the sexual toxicity was rated as maximum level. At the last follow up, after minimum 30 months, 37 of the patients (54.4%) did not present alterations of the erectile function. CONCLUSIONS: Low Dose Rate I 125 brachytherapy is considered a modern therapeutical procedure for low risk intracapsular prostate cancer, that is well tolerated, characterized by the lack of intraoperative or significant postoperative complications.
Eur Urol Suppl 2016; 15(11);e1405 Powered by TCPDF (www.tcpdf.org)
44
LDR I-125 brachytherapy as treatment for intracapsular prostate cancer Eur Urol Suppl 2016; 15(11);e1404
Brinzan D.M.1, Constantin T.V.2, Radu T.M.2, Ambert V.2, Braticevici B.2, Petca R.2, Rascu S.2, Badescu D.2, Kacso G.3, Jinga V.2 1
“Prof. Dr. Th. Burghele” Clinical Hospital, Dept. of Urology, Bucharest, Romania, 2Unversity of Medicine and Pharmacy Carol Davila, "Prof. Dr. Th. Burghele" Clinical Hospital, Department of Urology, Bucharest, Romania, 3Iuliu Hatieganu" University of Medicine and Pharmacy, "Prof. Dr. I. Chiricuta" Oncology Institute Radiotherapy II Department, Cluj, Romania INTRODUCTION & OBJECTIVES: Brachytherapy is considered a curative treatment option for patients diagnosed with localized prostate cancer. The current paper aims to examine Low Dose Rate I125 Brachytherapy as treatment for intracapsular prostate cancer. MATERIAL & METHODS: The studied group was composed of 80 patients diagnosed with intracapsular prostate cancer treated with LDR brachytherapy I-125 in the Radiotherapy Clinic of Oncology Institute "Al. Chiricuta " Cluj Napoca during January 2007 and June 2013. 35 of those patients where diagnosed with PC at Burghele clinical hospital and also came there for follow-up. The prevailing stage was T2a- 49 (61.3%) patients. The mean value of PSA was: 8.43ng/ml. 25 patients (31.25%) of the brachytherapy group have previously received hormonal treatment. All the patients of the group presented with an IPSS score of ≤12. The administered dose was 145 Gy. RESULTS: Postoperative clinical manifestations as well as early and late complications were monitored, developed secondary to urethral and rectal toxicity. PSA was monitored at 3, 6, 9, 12, 18, 24 months and then yearly. The survival rate at the end of the study was 92.5%. 6 deaths were registered, of which 2 were secondary to the underlying disease. Biochemical relapse was registered in 6 cases (7.5%). The PSA bounce phenomenon was encountered in 28 patients (35%). 37 patients (46.2%) developed grade I acute urinary toxicity (AUT), while 32 patients (40%) presented with AUT grade 2. In a significantly lower number of cases, AUT grade 3 symptoms were registered. Late urinary toxicity was evaluated at minimum 12 months. The most frequent grade of urinary toxicity was grade 1 – 36 patients (51.4%). 51 patients (63.75%) did not develop digestive symptoms (rectal toxicity), while in 25 cases grade 1 rectal toxicity was encountered. 2 patients presented with grade 2 rectal toxicity, while other 2 patients encountered grade 3. One year after brachytherapy seeds implantation, most of the patients 59 (84.29) did not present late rectal toxicity. 31 patients did not present any manifestations of acute sexual toxicity. In 24 cases (30%)
Eur Urol Suppl 2016; 15(11);e1404
EAU16th Central European Meeting, 7-8 October 2016, Vienna, Austria
44
LDR I-125 brachytherapy as treatment for intracapsular prostate cancer Eur Urol Suppl 2016; 15(11);e1405
grade 1 sexual toxicity was encountered and for 15 patients ( 18.75%) grade 2 sexual toxicity was encountered, while for 10 patients, the sexual toxicity was rated as maximum level. At the last follow up, after minimum 30 months, 37 of the patients (54.4%) did not present alterations of the erectile function. CONCLUSIONS: Low Dose Rate I 125 brachytherapy is considered a modern therapeutical procedure for low risk intracapsular prostate cancer, that is well tolerated, characterized by the lack of intraoperative or significant postoperative complications.
Eur Urol Suppl 2016; 15(11);e1405 Powered by TCPDF (www.tcpdf.org)