Feasibility and early outcome of high-dose-rate Ir-192 brachytherapy as monotherapy in two fractions within 1 day for high-/very high-risk prostate cancer

Ashida,Shingo; Yamasaki,Ichiro; Tamura,Kenji; Shimamoto,Tsutomu; Inoue,Keiji; Kariya,Shinji; Kobayashi,Kana; Yamagami,Takuji; Shuin,Taro

doi:10.3892/mco.2016.786

Feasibility and early outcome of high-dose-rate Ir-192 brachytherapy as monotherapy in two fractions within 1 day for high-/very high-risk prostate cancer

Authors:
- Shingo Ashida
- Ichiro Yamasaki
- Kenji Tamura
- Tsutomu Shimamoto
- Keiji Inoue
- Shinji Kariya
- Kana Kobayashi
- Takuji Yamagami
- Taro Shuin
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Affiliations: Department of Urology, Kochi Medical School, Nankoku, Kochi 783‑8505, Japan, Department of Diagnostic Radiology and Radiation Oncology, Kochi Medical School, Nankoku, Kochi 783‑8505, Japan
Published online on: February 22, 2016 https://doi.org/10.3892/mco.2016.786
Pages: 789-793

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Abstract

The aim of the present study was to evaluate the feasibility and preliminary outcomes of high-dose-rate (HDR)-brachytherapy as a monotherapy in two fractions within 1 day for localized prostate cancer, including high-/very high-risk cases. Among the 68 patients treated with HDR monotherapy between July 2011 and December 2014, 65 had a minimal follow-up of 12 months without adjuvant androgen deprivation therapy and were enrolled in the present study [42/65 (64.6%) exhibited high-/very high-risk diseases]. HDR monotherapy was performed in two fractions with a minimal interval of 6 h and the prescribed dose was 13.5 Gy (x2). Adverse events (AEs) were assessed using Common Terminology Criteria for Adverse Events (version 4; http://ctep.cancer.gov/protocolDevelopment/electronic_applications/ctc.htm#ctc_40), and biochemical failure was assessed by the Phoenix definition. The median follow‑up time was 30.1 months. The majority of patients had Grade 0‑1 acute AEs. Four patients (6.2%) exhibited urinary retention, requiring a Foley catheter. Grade 3 acute AEs occurred at a frequency of 3.1% and hematuria at 1.5%. The majority of patients also exhibited Grade 0‑1 chronic AEs. Grade 3 chronic AEs occurred at a frequency of 1.5% and urethral stricture at 1.5%, for which endoscopic treatment was indicated. Acute and chronic gastrointestinal AEs were uncommon, and no Grade 3 or above AEs developed. Biochemical failure occurred in 4 patients who all exhibited high‑/very high‑risk diseases. Kaplan‑Meier estimated that 3 year biochemical failure‑free survival was 91.6% overall and 88.0% in high‑/very high-risk cases. The present two‑fraction 1 day HDR monotherapy is feasible with minimal AEs and achieved acceptable biochemical control of localized prostate cancer, including high-/very high-risk cases, although long-term follow-up is required.

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