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High-dose-rate brachytherapy boost in prostate cancer: a New Zealand case series

Published online by Cambridge University Press:  23 December 2015

John K. L. Chin ,
Kenanao D. Rantshilane ,
Paul K. L. Chin ,
Anupam Chaudhuri ,
Leanne K. Tyrie  and
Cristian G. Hartopeanu
John K. L. Chin*
Affiliation:
Department of Radiation Oncology, Waikato Regional Cancer Centre, Waikato Hospital, Hamilton, New Zealand
Kenanao D. Rantshilane
Affiliation:
Department of Radiation Oncology, Waikato Regional Cancer Centre, Waikato Hospital, Hamilton, New Zealand
Paul K. L. Chin
Affiliation:
Department of Medicine, University of Otago, Christchurch, New Zealand
Anupam Chaudhuri
Affiliation:
Department of Radiation Oncology, Waikato Regional Cancer Centre, Waikato Hospital, Hamilton, New Zealand
Leanne K. Tyrie
Affiliation:
Department of Radiation Oncology, Waikato Regional Cancer Centre, Waikato Hospital, Hamilton, New Zealand
Cristian G. Hartopeanu
Affiliation:
Department of Radiation Oncology, Waikato Regional Cancer Centre, Waikato Hospital, Hamilton, New Zealand
*
Correspondence to: John Chin, Department of Radiation Oncology, Waikato Hospital, Pembroke Street, Private Bag 3200, Hamilton 3240, New Zealand. Tel: 6 407 839 8899. Fax: 6 407 839 8799. E-mail: john.chin@waikatodhb.health.nz
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Abstract

Aim

The aim of the present study was to report the survival outcomes and late toxicity of high-dose-rate brachytherapy (HDRBT) boost for dose escalation in patients with intermediate-to-high-risk prostate cancer.

Materials and methods

Retrospective data were collected from 137 patients who had undergone definitive radiotherapy for prostate cancer between 2006 and 2010. All patients had external-beam radiotherapy (median dose 46Gy) and HDRBT. Brachytherapy dose was 19Gy in two fractions (6 hours apart) with one implant using Ir-192.

Results

There were 94 high-risk and 43 intermediate-risk patients (NCCN classification). The median follow-up period was 60 months. The 5-year biochemical progression-free survival was 92 and 76% for intermediate- and high-risk groups, respectively. Prostate cancer-specific survival for the intermediate-risk group was 100% and for the high-risk group it was 92% at 5 years. For the entire cohort, the 5-year rate of urethral stricture formation was 13%, and the 5-year rate of late grade 2 and grade 3 gastrointestinal toxicity was 4·7 and 4·6%, respectively. There was no grade 3 or greater genitourinary toxicity.

Findings

Our data add to the growing body of literature supporting the use of HDRBT in prostate cancer. Late toxicity rates were marginally higher than that expected.

Keywords

intermediate to high riskIr-192survival outcomesurethral stricture
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 15 , Issue 1 , March 2016 , pp. 23 - 29
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Copyright
© Cambridge University Press 2015 

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