Document Detail


Comparison of tumor control and toxicity outcomes of high-dose intensity-modulated radiotherapy and brachytherapy for patients with favorable risk prostate cancer.
MedLine Citation:
PMID:  21195465     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To compare the long-term, prostate-specific antigen relapse-free survival outcome and incidence of toxicity for patients with low-risk prostate cancer who underwent brachytherapy or intensity-modulated radiotherapy (RT).
METHODS: A total of 729 consecutive patients underwent brachytherapy (n = 448; prescription dose 144 Gy) or intensity-modulated RT alone (n = 281; prescription dose 81 Gy). The prostate-specific antigen relapse-free survival using the nadir plus 2 ng/mL definition and late toxicity using the National Cancer Institute's Common Terminology Criteria for Adverse Events were determined.
RESULTS: The 7-year prostate-specific antigen relapse-free survival rate for the brachytherapy and intensity-modulated RT groups was 95% and 89% for low-risk patients, respectively (P = .004). Cox regression analysis demonstrated that brachytherapy was associated with improved prostate-specific antigen relapse-free survival, even after adjustment for other variables. The incidence of metastatic disease between treatment sessions was low for both treatment groups. Late grade 2 gastrointestinal toxicity was observed in 5.1% and 1.4% of the brachytherapy and intensity-modulated RT groups, respectively (P = .02). No significant differences were seen between treatment groups for late grade 3 or greater rectal complications (brachytherapy 1.1% and intensity-modulated RT 0%; P = .19). Late grade 2 urinary toxicity occurred more often in the brachytherapy group than in the intensity-modulated RT group (15.6% and 4.3%, respectively; P < .0001). No significant differences were seen between the 2 treatment groups for late grade 3 urinary toxicity (brachytherapy 2.2% and intensity-modulated RT 1.4%; P = .62).
CONCLUSIONS: Among low-risk prostate cancer patients, the 7-year biochemical tumor control was superior for intraoperatively planned brachytherapy compared with high-dose intensity-modulated RT. Although significant toxicities were minimal for both groups, modest, but significant, increases in grade 2 urinary and rectal symptoms were noted for brachytherapy compared with intensity-modulated RT.
Authors:
Michael J Zelefsky; Yoshiya Yamada; Xin Pei; Margie Hunt; Gilad Cohen; Zhigang Zhang; Marco Zaider
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-12-31
Journal Detail:
Title:  Urology     Volume:  77     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-11     Completed Date:  2011-07-04     Revised Date:  2014-05-29    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  986-90     Citation Subset:  IM    
Copyright Information:
Published by Elsevier Inc.
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MeSH Terms
Descriptor/Qualifier:
Brachytherapy* / adverse effects
Humans
Male
Penile Erection / radiation effects
Prostate-Specific Antigen / blood
Prostatic Neoplasms / mortality,  radiotherapy*
Radiotherapy / adverse effects,  methods
Radiotherapy Dosage
Radiotherapy, Conformal*
Retrospective Studies
Treatment Outcome
Grant Support
ID/Acronym/Agency:
P30 CA008748/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
EC 3.4.21.77/Prostate-Specific Antigen
Comments/Corrections
Comment In:
Urology. 2011 Apr;77(4):991-2; author reply 992-3   [PMID:  21477731 ]
Urology. 2011 Apr;77(4):991; author reply 992-3   [PMID:  21477730 ]
Nat Rev Urol. 2011 Mar;8(3):115   [PMID:  21513011 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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