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Nakamoto T, Yoshida T, Shiga T, Taguchi M, Mishima T, Kawakita S, Murota T, Kinoshita H. Re-salvage focal low-dose rate brachytherapy for local recurrence of prostate cancer after salvage focal low-dose rate brachytherapy. IJU Case Rep 2024; 7:68-72. [PMID: 38173462 PMCID: PMC10758911 DOI: 10.1002/iju5.12670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 11/01/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Salvage brachytherapy represents an effective treatment for local recurrence of prostate cancer after prior external beam radiotherapy. However, the optimal therapeutic strategies for local recurrence after salvage brachytherapy have not yet been determined. Case presentation We describe the case of a 77-year-old man who underwent re-salvage focal low-dose rate brachytherapy for local recurrence after carbon ion radiotherapy and salvage focal low-dose rate brachytherapy. We performed re-salvage focal low-dose rate brachytherapy for the recurrence with a different type of seed, which resulted in a significant reduction in the prostate-specific antigen level. During the 35-month follow-up after re-salvage focal low-dose rate brachytherapy, no recurrence of prostate cancer and no severe radiation-related toxicities were observed. Conclusion Our patient was successfully treated with re-salvage focal low-dose rate brachytherapy for local recurrence after salvage focal low-dose rate brachytherapy. This treatment strategy might be effective for such patients and is not associated with sexual dysfunction or severe adverse events.
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Affiliation(s)
- Takahiro Nakamoto
- Department of Urology and AndrologyKansai Medical UniversityOsakaJapan
| | - Takashi Yoshida
- Department of Urology and AndrologyKansai Medical UniversityOsakaJapan
| | - Toshiko Shiga
- Department of RadiologyKansai Medical University, Medical CenterOsakaJapan
| | - Makoto Taguchi
- Department of Urology and AndrologyKansai Medical University, Medical CenterOsakaJapan
| | - Takao Mishima
- Department of Urology and AndrologyKansai Medical University, Medical CenterOsakaJapan
| | - Shigenari Kawakita
- Department of Urology and AndrologyKansai Medical University, Medical CenterOsakaJapan
| | - Takashi Murota
- Department of Urology and AndrologyKansai Medical University, Medical CenterOsakaJapan
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Kato M, Higashi S, Sugino Y, Kajiwara S, Tanaka S, Kitano G, Yamashita Y, Ogura Y, Tachibana H, Kojima T, Inoue T. Clinical Efficacy and Openness to New Challenges of Low Dose Rate Brachytherapy for Prostate Cancer. Curr Oncol 2023; 30:9824-9835. [PMID: 37999133 PMCID: PMC10670683 DOI: 10.3390/curroncol30110713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/02/2023] [Accepted: 11/05/2023] [Indexed: 11/25/2023] Open
Abstract
Over a century ago, low-dose-rate (LDR) brachytherapy was introduced to treat prostate cancer (PCa). Since then, it has been widely applied worldwide, including in East Asia. LDR brachytherapy has been performed in 88 institutes in Japan. Beneficial clinical outcomes of LDR brachytherapy for intermediate-to-high-risk PCa have been demonstrated in large clinical trials. These clinical outcomes were achieved through advances in methods, such as urological precise needle puncture and seed placement, and the quantitative decision making regarding radiological parameters by radiation oncologists. The combined use of LDR brachytherapy with other therapeutic modalities, such as external beam radiation and androgen deprivation therapy, for the clinical risk classification of PCa has led to better anticancer treatment efficacy. In this study, we summarized basic LDR brachytherapy findings that should remain unchanged and be passed down in urology departments. We also discussed the applications of LDR brachytherapy for PCa in various clinical settings, including focal and salvage therapies. In addition, we highlighted technologies associated with brachytherapy that are under development.
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Affiliation(s)
- Manabu Kato
- Aichi Cancer Center, Urology, Nagoya 464-8681, Japan; (S.T.); (G.K.); (H.T.); (T.K.)
| | - Shinichiro Higashi
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu 514-0001, Japan; (S.H.); (Y.S.); (S.K.); (T.I.)
| | - Yusuke Sugino
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu 514-0001, Japan; (S.H.); (Y.S.); (S.K.); (T.I.)
| | - Shinya Kajiwara
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu 514-0001, Japan; (S.H.); (Y.S.); (S.K.); (T.I.)
| | - Shiori Tanaka
- Aichi Cancer Center, Urology, Nagoya 464-8681, Japan; (S.T.); (G.K.); (H.T.); (T.K.)
| | - Goshi Kitano
- Aichi Cancer Center, Urology, Nagoya 464-8681, Japan; (S.T.); (G.K.); (H.T.); (T.K.)
| | | | - Yuji Ogura
- Kuwana City Medical Center, Urology, Kuwana 511-0061, Japan;
| | - Hiroyuki Tachibana
- Aichi Cancer Center, Urology, Nagoya 464-8681, Japan; (S.T.); (G.K.); (H.T.); (T.K.)
| | - Takahiro Kojima
- Aichi Cancer Center, Urology, Nagoya 464-8681, Japan; (S.T.); (G.K.); (H.T.); (T.K.)
| | - Takahiro Inoue
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu 514-0001, Japan; (S.H.); (Y.S.); (S.K.); (T.I.)
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Kamitani N, Miyaji Y, Tamada T, Yoden E, Kawata Y, Watanabe K, Tokiya R, Nagai A, Katsui K. Feasibility of magnetic resonance imaging-ultrasound guided high-dose-rate brachytherapy for localized prostate cancer: Preliminary results from a prospective study. Int J Urol 2022; 29:725-732. [PMID: 35355325 DOI: 10.1111/iju.14880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/21/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to investigate preliminary outcomes of a prospective trial of magnetic resonance imaging-ultrasound fusion-guided ultrafocal high-dose-rate brachytherapy in localized prostate cancer. METHODS In our prospective study, data from patients who underwent this treatment between April 1, 2020 and March 31, 2021 were analyzed. In the procedure, the applicator needle was inserted through the perineum to target the lesion on the multiparametric magnetic resonance imaging, which was fused onto the transrectal ultrasound image. The prescription dose was set at a single fraction of 19 Gy. Data from patients who received whole-gland high-dose-rate brachytherapy were extracted and compared with data from patients who received ultrafocal high-dose-rate brachytherapy, to evaluate the frequency of acute adverse events. RESULTS Eight patients underwent ultrafocal high-dose-rate brachytherapy with a median observation period of 7.75 months (range 5.96-15.36 months). No acute genitourinary or gastrointestinal adverse events were observed in this cohort. The planned procedure was completed in all patients, and no unexpected adverse events were observed; however, prostate-specific antigen failure was detected in one patient. In the 25 patients who underwent whole-gland high-dose-rate brachytherapy, acute genitourinary and gastrointestinal adverse events were observed in 88% and 20% of the patients, respectively. Ultrafocal high-dose-rate brachytherapy was a significant factor in avoiding acute adverse genitourinary events in univariate and multivariate analyses (P < 0.001 and P = 0.032, respectively). CONCLUSIONS Magnetic resonance imaging-ultrasound fusion-guided ultrafocal high-dose-rate brachytherapy in localized prostate cancer is a safe and feasible treatment without acute genitourinary and gastrointestinal adverse events. Long-term observation and further investigation are warranted.
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Affiliation(s)
- Nobuhiko Kamitani
- Departments of Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Yoshiyuki Miyaji
- Department of Urology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Tsutomu Tamada
- Departments of Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Eisaku Yoden
- Departments of Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Yujiro Kawata
- Departments of Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Kenta Watanabe
- Departments of Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Ryouji Tokiya
- Departments of Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Atsushi Nagai
- Department of Urology, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Kuniaki Katsui
- Departments of Radiology, Kawasaki Medical School, Kurashiki, Okayama, Japan
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Shah C, Vicini F, Beriwal S, Thaker N, Frank SJ, Rossi P, Orio P, Chang AJ, Joshi N, Campbell SR, Naghavi A, Chao S, Kamrava M, Deufel CL, Mourtada F, Suh JH. American brachytherapy society radiation oncology alternative payment model task force: Quality measures and metrics for brachytherapy. Brachytherapy 2021; 21:63-74. [PMID: 34732290 DOI: 10.1016/j.brachy.2021.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 09/26/2021] [Accepted: 10/05/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE Brachytherapy is an essential technique to deliver radiation therapy and is involved in the treatment of multiple disease sites as monotherapy or as an adjunct to external beam radiation therapy. With a growing focus on the cost and value of cancer treatments as well new payment models, it is essential that standardized quality measures and metrics exist to allow for straightforward assessment of brachytherapy quality and for the development of clinically significant and relevant clinical data elements. We present the American Brachytherapy Society consensus statement on quality measures and metrics for brachytherapy as well as suggested clinical data elements. METHODS AND MATERIALS Members of the American Brachytherapy Society with expertise in disease site specific brachytherapy created a consensus statement based on a literature review and clinical experience. RESULTS Key quality measures (ex. workup, clinical indications), dosimetric metrics, and clinical data elements for brachytherapy were evaluated for each modality including breast cancer, cervical cancer, endometrial cancer, prostate cancer, keratinocyte carcinoma, soft tissue sarcoma, and uveal melanoma. CONCLUSIONS This consensus statement provides standardized quality measures and dosimetric quality metrics as well as clinical data elements for each disease site to allow for standardized assessments of brachytherapy quality. Moving forward, a similar paradigm can be considered for external beam radiation therapy as well, providing comprehensive radiation therapy quality measures, metrics, and clinical data elements that can be incorporated into new payment models.
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Affiliation(s)
- Chirag Shah
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH.
| | | | - Sushil Beriwal
- Department of Radiation Oncology, UPMC Hillman cancer Center, Pittsburgh, PA
| | - Nikhil Thaker
- Division of Radiation Oncology, Arizona Oncology, Tucson, AZ
| | - Steven J Frank
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, TX
| | | | - Peter Orio
- Department of Radiation Oncology, Dana Farber Cancer Institute, Boston, MA
| | - Albert J Chang
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA
| | - Nikhil Joshi
- Department of Radiation Oncology, Rush University, Chicago, IL
| | - Shauna R Campbell
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - Arash Naghavi
- Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL
| | - Samuel Chao
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
| | - Mitchell Kamrava
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA
| | | | - Firas Mourtada
- Department of Radiation Oncology, Helen F. Graham Cancer Center, ChristianaCare, Newark, DE
| | - John H Suh
- Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH
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Mantica G, Chierigo F, Suardi N, Gomez Rivas J, Kasivisvanathan V, Papalia R, Fiori C, Porpiglia F, Terrone C, Esperto F. Minimally invasive strategies for the treatment of prostate cancer recurrence after radiation therapy: a systematic review. MINERVA UROL NEFROL 2020; 72:563-578. [PMID: 32748617 DOI: 10.23736/s0393-2249.20.03783-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The aim of this review was to conduct a comprehensive analysis of the role of minimally invasive salvage modalities in radio-recurrent prostate cancer and the associated clinical outcomes and toxicity profiles. EVIDENCE ACQUISITION A systematic review of the current literature was conducted through the Medline and NCBI PubMed, Scopus databases in January 2020. All papers published after 2000, concerning studies conducted on humans for radio-recurrent prostate cancer were considered for the review. EVIDENCE SYNTHESIS Overall, 545 studies were identified. After duplicate exclusion, initial screening, and eligibility evaluation, a total of 80 studies were included in the qualitative analysis, corresponding to a cohort of 6681 patients. The median age at initial diagnosis ranged from 59 to 75.5. Pre-treatment PSA ranged from 6.2 to 27.4 ng/mL. All patients underwent primary radiotherapy for localized prostate cancer. Cryotherapy, Brachytherapy, EBRT, HIFU were the minimally invasive options mostly used as salvage therapy. They showed to be promising approaches for recurrent prostate cancer (PCa) control, with acceptable toxicities. CONCLUSIONS Minimally invasive therapeutic options offer promising results in terms of biochemical control in the local recurrence setting. Unfortunately, the absence of high quality and comparative studies makes it difficult to establish which method is the best in terms of oncological and safety outcomes.
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Affiliation(s)
- Guglielmo Mantica
- Department of Urology, San Martino University Hospital, University of Genoa, Genoa, Italy
| | - Francesco Chierigo
- Department of Urology, San Martino University Hospital, University of Genoa, Genoa, Italy -
| | - Nazareno Suardi
- Department of Urology, San Martino University Hospital, University of Genoa, Genoa, Italy
| | - Juan Gomez Rivas
- Department of Urology, La Paz University Hospital, Madrid, Spain.,Instituto de Investigación Sanitaria La Paz (IdiPAZ), Madrid, Spain
| | - Veeru Kasivisvanathan
- UCL Division of Surgery and Interventional Sciences, University College London, London, UK
| | - Rocco Papalia
- Department of Urology, Campus Bio-Medico University, Rome, Italy
| | - Cristian Fiori
- Division of Urology, Department of Oncology, San Luigi Hospital, School of Medicine, University of Turin, Orbassano, Turin, Italy
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology, San Luigi Hospital, School of Medicine, University of Turin, Orbassano, Turin, Italy
| | - Carlo Terrone
- Department of Urology, San Martino University Hospital, University of Genoa, Genoa, Italy
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Yamada Y, Ukimura O, Kaneko M, Matsugasumi T, Fujihara A, Vourganti S, Marks L, Sidana A, Klotz L, Salomon G, de la Rosette J. Moving away from systematic biopsies: image-guided prostate biopsy (in-bore biopsy, cognitive fusion biopsy, MRUS fusion biopsy) -literature review. World J Urol 2020; 39:677-686. [PMID: 32728885 DOI: 10.1007/s00345-020-03366-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 07/11/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To compare the detection rate of clinically significant cancer (CSCa) by magnetic resonance imaging-targeted biopsy (MRI-TB) with that by standard systematic biopsy (SB) and to evaluate the role of MRI-TB as a replacement from SB in men at clinical risk of prostate cancer. METHODS The non-systematic literature was searched for peer-reviewed English-language articles using PubMed, including the prospective paired studies, where the index test was MRI-TB and the comparator text was SB. Also the randomized clinical trials (RCTs) are included if one arm was MRI-TB and another arm was SB. RESULTS Eighteen prospective studies used both MRI-TB and TRUS-SB, and eight RCT received one of the tests for prostate cancer detection. In most prospective trials to compare MRI-TB vs. SB, there was no significant difference in any cancer detection rate; however, MRI-TB detected more men with CSCa and fewer men with CISCa than SB. CONCLUSION MRI-TB is superior to SB in detection of CSCa. Since some significant cancer was detected by SB only, a combination of SB with the TB technique would avoid the underdiagnosis of CSCa.
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Affiliation(s)
- Yasuhiro Yamada
- Department of Urology, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kyoto, 602-8566, Japan
| | - Osamu Ukimura
- Department of Urology, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kyoto, 602-8566, Japan.
| | - Masatomo Kaneko
- Department of Urology, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kyoto, 602-8566, Japan
| | - Toru Matsugasumi
- Department of Urology, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kyoto, 602-8566, Japan
| | - Atsuko Fujihara
- Department of Urology, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kyoto, 602-8566, Japan
| | | | - Leonard Marks
- Department of Urology, University of California, Los Angeles, CA, USA
| | - Abhinav Sidana
- Urologic Oncology Branch, National Cancer Institute, Bethesda, MD, USA
| | - Laurence Klotz
- Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Georg Salomon
- Prostate Cancer Centre, Martini Clinic, University Medical Centre Eppendorf, Hamburg, Germany
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Tay KJ. Editorial Comment to Focal salvage low-dose-rate brachytherapy for recurrent prostate cancer based on magnetic resonance imaging/transrectal ultrasound fusion biopsy technique. Int J Urol 2019; 27:155-156. [PMID: 31786818 DOI: 10.1111/iju.14159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Kae Jack Tay
- Department of Urology, Singapore General Hospital, Singapore.,Duke-NUS Graduate Medical School, SingHealth Duke-NUS Academic Medical Center, Singapore
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