NEW YORK (Reuters Health) Dec 26 - High-dose rate brachytherapy (HDR) is safe and effective in patients with intermediate-risk prostate cancer, according to a small study online November 16 in the Journal of Urology.
"There is limited data relating specifically to patients with intermediate-risk prostate cancer," Dr. C. Leland Rogers told Reuters Health by email. "We have documented remarkably good results for intermediate-risk patients treated with HDR brachytherapy alone."
Dr. Rogers, of GammaWest Cancer Services in Salt Lake City, added that there is still disagreement as to whether intermediate-risk patients benefit from adding androgen-deprivation therapy to radiation.
To gain further information, his team retrospectively studied data on 284 patients who were followed for a mean of almost three years.
Actuarial five-year cause-specific survival was 100%. Distant-metastasis-free survival was 98.8%, and biochemical disease-free survival was 94.4%.
For clinical stage T2a or less, five-year biochemical disease-free survival was 95.1%. For stage T2b, it was 100% and for stage T2c it was 77.4%. International Prostate Symptom Scores remained stable and potency was maintained in 82.6% of patients at two years.
"I am unaware of published outcomes this favorable... from any treatment other than brachytherapy, and HDR brachytherapy alone achieves this with a very favorable side effect profile," Dr. Rogers said.
The researchers advise caution in using the approach in patients with clinical stage T2c or positive biopsy cores with values greater than 75%.
"We currently recommend that such patients be treated more aggressively," they say, "analogous to our approach for those at high risk."
Twenty-two patients (8%) used pads for the first time mainly for grade 1 incontinence, while 12 (4%) developed Radiation Therapy Oncology Group grade 1 rectal toxicity.
No patients had urethral stricture and none required surgical gastrointestinal intervention.
With appropriate individualized attention and selection, the team concludes that the approach is "effective and well tolerated" and "hormonal therapy and external beam radiation therapy do not appear to be necessary adjuncts."
Moreover, Dr. Rogers said, "HDR brachytherapy as monotherapy is highly conformal (i.e. treats the prostate to a tumoricidal dose, with tight margins, and with limited dose to surrounding healthy tissues), and is cost effective. We are hopeful that this will encourage other centers to adopt this treatment, develop it further with us, and become expert."
SOURCE: http://bit.ly/tRu2KK
"There is limited data relating specifically to patients with intermediate-risk prostate cancer," Dr. C. Leland Rogers told Reuters Health by email. "We have documented remarkably good results for intermediate-risk patients treated with HDR brachytherapy alone."
Dr. Rogers, of GammaWest Cancer Services in Salt Lake City, added that there is still disagreement as to whether intermediate-risk patients benefit from adding androgen-deprivation therapy to radiation.
To gain further information, his team retrospectively studied data on 284 patients who were followed for a mean of almost three years.
Actuarial five-year cause-specific survival was 100%. Distant-metastasis-free survival was 98.8%, and biochemical disease-free survival was 94.4%.
For clinical stage T2a or less, five-year biochemical disease-free survival was 95.1%. For stage T2b, it was 100% and for stage T2c it was 77.4%. International Prostate Symptom Scores remained stable and potency was maintained in 82.6% of patients at two years.
"I am unaware of published outcomes this favorable... from any treatment other than brachytherapy, and HDR brachytherapy alone achieves this with a very favorable side effect profile," Dr. Rogers said.
The researchers advise caution in using the approach in patients with clinical stage T2c or positive biopsy cores with values greater than 75%.
"We currently recommend that such patients be treated more aggressively," they say, "analogous to our approach for those at high risk."
Twenty-two patients (8%) used pads for the first time mainly for grade 1 incontinence, while 12 (4%) developed Radiation Therapy Oncology Group grade 1 rectal toxicity.
No patients had urethral stricture and none required surgical gastrointestinal intervention.
With appropriate individualized attention and selection, the team concludes that the approach is "effective and well tolerated" and "hormonal therapy and external beam radiation therapy do not appear to be necessary adjuncts."
Moreover, Dr. Rogers said, "HDR brachytherapy as monotherapy is highly conformal (i.e. treats the prostate to a tumoricidal dose, with tight margins, and with limited dose to surrounding healthy tissues), and is cost effective. We are hopeful that this will encourage other centers to adopt this treatment, develop it further with us, and become expert."
SOURCE: http://bit.ly/tRu2KK
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου