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Sakurai T, Takamatsu S, Shibata S, Minamikawa R, Yamazaki M, Okubo A, Nagaoka R, Makino T, Naito R, Yaegashi H, Mizokami A, Kobayashi S. Urinary tract symptoms that should be improved to enhance post-operative urinary quality of life in patients treated with low-dose-rate brachytherapy for prostate cancer: An importance-performance analysis. J Contemp Brachytherapy 2024; 16:12-20. [PMID: 38584886 PMCID: PMC10993896 DOI: 10.5114/jcb.2024.135646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 01/26/2024] [Indexed: 04/09/2024] Open
Abstract
Purpose To evaluate international prostate symptom score and urinary quality of life in patients with prostate cancer who underwent low-dose-rate brachytherapy, and to identify lower urinary tract symptoms that must be improved to enhance post-operative urinary quality of life and factors associated with lower urinary tract symptoms. Material and methods This study included 193 patients who underwent low-dose-rate brachytherapy alone (145 Gy). Importance-performance analysis was conducted to identify lower urinary tract symptoms that should be prioritized to improve urinary quality of life. Association between lower urinary tract symptom scores and each factor was investigated. Receiver operating characteristic curve analysis was used to evaluate dosimetric parameters related to lower urinary tract symptom score to predict an average score of ≥ 3. Cut-off values were determined. Results One to nine months post-implantation was a period of significantly increased urinary quality of life scores compared with baseline (p < 0.05 each). The importance-performance analysis conducted for 1-9 months revealed that frequency, nocturia, and weak stream required improvement. Multivariate analysis showed that each lower urinary tract symptom score presented a significant association with its baseline value (p < 0.001 each, positive correlation). Frequency, incomplete emptying, urgency, and straining scores were significantly associated with prostate volume, whereas weak stream and intermittency scores were associated with dose covering 90% of the prostate and dose covering 90% of the urethra, respectively (p < 0.05 each, positive correlations). Cut-off values for these doses were 167.01 Gy and 136.84 Gy, respectively. Conclusions This study highlights the importance of prioritizing specific lower urinary tract symptoms for improvement in post-operative urinary quality of life, and identifies the associated factors that can help in personalized treatment planning and goal-setting for better patient satisfaction.
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Affiliation(s)
- Takayuki Sakurai
- Department of Radiology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Shigeyuki Takamatsu
- Department of Radiology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Satoshi Shibata
- Department of Radiology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Risako Minamikawa
- Department of Radiology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Masahiro Yamazaki
- Department of Radiology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Akihito Okubo
- Department of Radiology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Risa Nagaoka
- Department of Radiology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Tomoyuki Makino
- Department of Integrative Cancer Therapy and Urology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Renato Naito
- Department of Integrative Cancer Therapy and Urology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Hiroshi Yaegashi
- Department of Integrative Cancer Therapy and Urology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Atsushi Mizokami
- Department of Integrative Cancer Therapy and Urology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Satoshi Kobayashi
- Department of Radiology, Graduate School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
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Gesztesi L, Kocsis ZS, Jorgo K, Fröhlich G, Polgár C, Ágoston P. Alterations of Sexual and Erectile Functions after Brachytherapy for Prostate Cancer Based on Patient-Reported Questionnaires. Prostate Cancer 2024; 2024:5729185. [PMID: 38312318 PMCID: PMC10834089 DOI: 10.1155/2024/5729185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 11/16/2023] [Accepted: 01/08/2024] [Indexed: 02/06/2024] Open
Abstract
The aim of the study was to compare the side effects of high-dose-rate brachytherapy (HDRBT) and low-dose-rate brachytherapy (LDRBT), with a particular focus on the effects on sexual functions and sexual well-being (PROMOBRA study, NCT02258087). Localized low-risk and low-intermediate-risk prostate cancer patients were treated with mono LDR (N = 123, 145 Gy dose) or mono HDR brachytherapy (N = 117, 19/21 Gy). Prior to the treatment and during follow-up (at 3, 6, 9, 12, 18, and 24 months after treatment, and then annually after two years), patients completed patient-reported outcome measurement (PROM) questionnaires EORTC QLQ-PR-25, International Index of Erectile Function (IIEF), and IIEF-5 (SHIM). We compared the patients in different group breakdowns (HDR vs. LDR, hormone naïve and hormone-receiving HDR vs. LDR, hormone naïve and hormone-receiving patients in general, and 19 Gy HDR vs. 21 Gy HDR). In the hormone-naive LDR group, erectile function, orgasm function, sexual desire, satisfaction with intercourse, and overall satisfaction functions significantly decreased compared to baseline throughout the whole follow-up period. However, there were significant decreases in function at a maximum of three time points after HDR therapy without hormone therapy. In hormone-receiving patients, the orgasm function was significantly better in the HDR group at multiple time points compared to the baseline, and sexual desire improved at four time points. According to our results, both LDRBT and HDRBT can be safely administered to patients with localized prostate cancer. In hormone-naive patients, the HDR group showed only recovering decreases in sexual functions, while the LDR group showed a lasting decline in multiple areas. Thus, HDR appears to be more advantageous to hormone-naive patients.
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Affiliation(s)
- László Gesztesi
- National Institute of Oncology, Centre of Radiotherapy, Budapest, Hungary
| | - Zsuzsa S. Kocsis
- National Institute of Oncology, Centre of Radiotherapy, Department of Radiobiology and Diagnostic Onco-Cytogenetics and National Tumorbiology Laboratory, Budapest, Hungary
| | - Kliton Jorgo
- National Institute of Oncology, Centre of Radiotherapy, Budapest, Hungary
- Semmelweis University, Department of Oncology, Budapest, Hungary
| | - Georgina Fröhlich
- National Institute of Oncology, Centre of Radiotherapy, Budapest, Hungary
| | - Csaba Polgár
- National Institute of Oncology, Centre of Radiotherapy, Budapest, Hungary
- Semmelweis University, Department of Oncology, Budapest, Hungary
| | - Péter Ágoston
- National Institute of Oncology, Centre of Radiotherapy, Budapest, Hungary
- Semmelweis University, Department of Oncology, Budapest, Hungary
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Li X, Shan L, Wang Q, Zhai H, Xuan Y, Yan G. Comparison of chronic gastrointestinal and genitourinary toxicities between brachytherapy and external beam radiotherapy for patients with prostate cancer: A systematic review and meta-analysis. Technol Health Care 2023; 31:357-372. [PMID: 37066936 DOI: 10.3233/thc-236031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
BACKGROUND 125I BT is an effective radiotherapy for prostate cancer. However, comparison data of GI and GU toxicities between BT, BT + EBRT, and EBRT-alone patient groups is limited. OBJECTIVE To define the GI and GU toxicities in prostate cancer to prevent adverse events after treatment. METHODS We searched published studies in PubMed, Cochrane, and Embase databases up to December 31, 2022. The endpoints were the RRs of GI and GU toxicities. Pooled data were assessed using a random-effects model. RESULTS Fifteen eligible studies were included into this analysis. LDR-BT had significantly lower RRs than LDR-BT + EBRT for acute GI (2.13; 95% CI, 1.22-3.69; P= 0.007) and late GI toxicities (3.96; 95% CI, 1.23-12.70; P= 0.02). Moreover, EBRT had significantly higher RRs than LDR-BT for acute GU (2.32; 95% CI, 1.29-4.15; P= 0.005) and late GU toxicities (2.38; 95% CI, 1.27-4.44; P= 0.007). HDR-BT had significantly higher RRs for acute GU toxicities than LDR-BT alone (0.30; 95% CI, 0.23-0.40; P< 0.00001). CONCLUSION The results implied that BT with and without EBRT can result in both GI and GU toxicities in patients with prostate cancer, with LDR-BT leading to a poorer urinary function than EBRT.
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Affiliation(s)
- Xuanzhe Li
- Department of Nuclear Medicine, Hospital of Haicang, Xiamen, Fujian, China
- Department of Nuclear Medicine, Hospital of Haicang, Xiamen, Fujian, China
| | - Ligang Shan
- Department of Anesthesiology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China
- Department of Nuclear Medicine, Hospital of Haicang, Xiamen, Fujian, China
| | - Qianqi Wang
- Department of Radiology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China
| | - Huige Zhai
- Department of Radiology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China
| | - Yinghua Xuan
- Department of Basic Medicine, Xiamen Medical College, Xiamen, Fujian, China
| | - Gen Yan
- Department of Radiology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China
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Wang H, Shi HB, Qiang WG, Wang C, Sun B, Yuan Y, Hu WW. CT-guided Radioactive 125I Seed Implantation for Abdominal Incision Metastases of Colorectal Cancer: Safety and Efficacy in 17 Patients. Clin Colorectal Cancer 2023; 22:136-142. [PMID: 36463020 DOI: 10.1016/j.clcc.2022.10.004] [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: 07/12/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION To retrospectively evaluate the safety and efficacy of computed tomography (CT)-guided iodine-125 (125I) seed implantation for patients with abdominal incision metastases from colorectal cancer. MATERIALS AND METHODS Data of patients with abdominal incision metastases of colorectal cancer from November 2010 to October 2020 were retrospectively reviewed. Each incisional metastasis was percutaneously treated with 125I seed implantation under CT guidance. Follow-up contrast-enhanced CT was reviewed, and the outcomes were evaluated in terms of objective response rate, complications, and overall survival. RESULTS A total of 17 patients were enrolled in this study. The median follow-up was 18 months (range, 2.7-22.1 months). At 3, 6, 12, and 18 months after the treatment, objective response rate was 52.9%, 63.6%, 33.3%, and 0%, respectively. A small amount of local hematoma occurred in two patients and resolved spontaneously without any treatment. Two patients experienced a minor displacement of radioactive seeds with no related symptoms. Severe complications, such as massive bleeding and radiation injury, were not observed. No ≥ grade 3 adverse events were identified. By the end of follow-up, 14 patients died of multiple hematogenous metastases. The one-year overall survival rate was 41.6%, and the median overall survival was 8.6 months. CONCLUSION CT-guided 125I seed implantation brachytherapy is safe and feasible for patients with abdominal incision metastases from colorectal cancer.
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Affiliation(s)
- Hao Wang
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Hong-Bing Shi
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Wei-Guang Qiang
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Chao Wang
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Bai Sun
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Ye Yuan
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China
| | - Wen-Wei Hu
- Center of Oncology, The Third Affiliated Hospital, Soochow University, Changzhou, China.
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Amanuel F. Nuclear model prediction of cross-section for 125 - 119I radionuclides produced in proton + 125Te reaction at ≈ 5–100 MeV. Appl Radiat Isot 2022; 188:110351. [DOI: 10.1016/j.apradiso.2022.110351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 06/02/2022] [Accepted: 06/26/2022] [Indexed: 11/02/2022]
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Toxicity in patients treated with permanent prostate brachytherapy using intraoperatively built custom-linked seeds versus loose seeds. J Contemp Brachytherapy 2021; 12:547-553. [PMID: 33437302 PMCID: PMC7787198 DOI: 10.5114/jcb.2020.101687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 10/23/2020] [Indexed: 12/20/2022] Open
Abstract
Purpose Low-dose-rate brachytherapy (BT) with permanent iodine-125 radioactive seeds is a highly effective treatment option for low- and favorable intermediate-risk prostate cancer. However, optimal implantation is not always achieved due to edema or seeds loss. One way to improve seed placement is the use of stranded seeds called "intraoperatively built custom-linked seeds (IBCLS)" in an opposition to loose seeds (LS). To date, there are few data comparing toxicity rates between these two techniques. The aim of this study was to compare dosimetric parameters and toxicity rates at 2 years between both procedures in a matched-paired population. Material and methods Patients were considered for BT according to European guidelines. Among 548 patients treated at our institution, 105 patients in the loose seeds cohort were individually matched to 105 patients in the IBCLS group according to age, prostate volume, pre-operative international prostate symptom score (IPSS), clinical stage, and Gleason score. Erectile function was scored using the five-item international index of erectile function (IIEF-5) score. A multivariable linear mixed-effects model was applied to examine the association between total and individual scores (repeated measures) and covariates. Results Overall, 61 (29%) patients presented with a favorable intermediate-risk prostate cancer. There were no significant changes in IPSS over time (p = 0.57). During follow-up, the IIEF-5 was similar in the two groups, except at one month, where it was lower in the IBCLS group (10.9 vs. 6.9, p = 0.029). Also, there was no difference in grade ≥ 2 rectal toxicity. At 1 month, D90Gy, V150%, and V100% were higher in the LS group compared to the IBCLS group. Conclusions Low-dose-rate prostate brachytherapy using IBCLS is a safe technique, with comparable toxicity profiles at 2 years compared to LS brachytherapy.
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Wu C, Li B, Sun G, Peng C, Xiang D. Efficacy and Safety of Iodine-125 Brachytherapy in the Treatment of Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma. Onco Targets Ther 2020; 13:9657-9666. [PMID: 33061447 PMCID: PMC7535121 DOI: 10.2147/ott.s269626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 08/31/2020] [Indexed: 11/23/2022] Open
Abstract
Background Recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) is a difficult challenge for physicians, especially when patients have been treated with external beam radiotherapy. The purpose of this study was to assess the clinical efficacy and safety of computed tomography (CT)-guided iodine-125 brachytherapy as a palliative treatment for R/M HNSCC. Methods From May 2011 to July 2018, we enrolled 87 patients with R/M HNSCC who had previously received external beam radiotherapy. Among these patients, 43 successfully underwent CT-guided iodine-125 brachytherapy and chemotherapy (group A); 44 patients who only received chemotherapy (group B) were matched with patients in group A. Patients' pain score, Eastern Cooperative Oncology Group (ECOG) score, tumor compression symptoms, and side effects of iodine-125 implantation were recorded. Clinical follow-up was performed to assess progression-free survival (PFS) and overall survival (OS). Results Both groups of patients completed the treatment and were followed up for 9-66 months, with a median follow-up time of 44 months. The OS was 51 months (95% CI: 42.93-59.06 months) versus 28 months (95% CI: 23.79-32.21 months) (p < 0.05), the PFS was 10 months (95% CI: 6.15-13.84 months) versus 6 months (95% CI: 4.40-7.59 months) (p < 0.05) in groups A and B, respectively. The RR in group A was 25/43 (58.14%) versus 15/44 (34.10%) in group B (p < 0.05). Compared with group B, patients in group A had lower pain scores, better physical performance, and better improvement of compression symptoms. No serious treatment-related complications were observed in either group of patients. Conclusion Compared with chemotherapy alone, iodine-125 seed implantation combined with chemotherapy was a more effective and safer strategy for R/M HNSCC.
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Affiliation(s)
- Chunrong Wu
- Department of Oncology, Jiangjin Central Hospital of Chongqing, Jiangjin, Chongqing 402260, People's Republic of China
| | - Bo Li
- Department of Cardiology, Jiangjin Central Hospital of Chongqing, Jiangjin, Chongqing 402260, People's Republic of China
| | - Guiyin Sun
- Department of Oncology, Jiangjin Central Hospital of Chongqing, Jiangjin, Chongqing 402260, People's Republic of China
| | - Chunfang Peng
- Department of Oncology, Jiangjin Central Hospital of Chongqing, Jiangjin, Chongqing 402260, People's Republic of China
| | - Debing Xiang
- Department of Oncology, Jiangjin Central Hospital of Chongqing, Jiangjin, Chongqing 402260, People's Republic of China
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Wang H, Lu J, Zheng XT, Zha JH, Jing WD, Wang Y, Zhu GY, Zeng CH, Chen L, Guo JH. Oligorecurrence Non-small Cell Lung Cancer After Failure of First-Line Chemotherapy: Computed Tomography-Guided 125I Seed Implantation vs. Second-Line Chemotherapy. Front Oncol 2020; 10:470. [PMID: 32373512 PMCID: PMC7179670 DOI: 10.3389/fonc.2020.00470] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/16/2020] [Indexed: 12/28/2022] Open
Abstract
Purpose: To compare the efficacy and safety of computed tomography (CT)–guided 125I seed implantation with second-line chemotherapy in treatment of oligorecurrence non–small cell lung cancer after failure of first-line chemotherapy. Methods: Data of oligorecurrence non–small cell lung cancer patients after failure of first-line chemotherapy at two institutions were retrospectively reviewed from January 2013 to July 2018. A total of 53 patients who received the treatment of 125I seed implantation or second-line chemotherapy were eligible for this study. In group A, 25 patients, 84 lesions, received CT-guided permanent 125I seed implantation, whereas in group B, 28 patients, 96 lesions, received second-line chemotherapy. The outcomes were measured in terms of disease control rate, overall survival, quality of life, and complications. Results: The median follow-up period was 13 months (range, 5–42 months). Disease control rate in group A was higher than that in group B (70.8 vs. 42.3%, P = 0.042) at 6 months after treatment. The median overall survival was 12.8 months (95% confidence interval, 10.5–15.1 months) in group A and 15.2 months (95% confidence interval, 12.2–18.2 months) in group B, with no significant difference (P = 0.847). Since the fourth month, the number of patients in group A with a non-decreasing Karnofsky Performance Scale score was more than that in group B (P < 0.05). The incidence of grade 3 or higher complications especially hematologic toxicity in group A was significantly lower than that in group B (P < 0.05). Conclusion: Radioactive 125I seed implantation is safe and feasible in selected non–small cell lung cancer patients with oligorecurrence after failure of first-line chemotherapy and seems to provide a better long-term quality of life in these patients compared with second-line chemotherapy.
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Affiliation(s)
- Hao Wang
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Jian Lu
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Xiao-Ting Zheng
- Center of Oncology, Tianchang City Hospital of Chinese Medicine, Chuzhou, China
| | - Jun-Hao Zha
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Wen-Dong Jing
- Center of Oncology, Tianchang City Hospital of Chinese Medicine, Chuzhou, China
| | - Yong Wang
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Guang-Yu Zhu
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Chu-Hui Zeng
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Lei Chen
- Department of Intervention and Vascular Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Jin-He Guo
- Center of Interventional Radiology and Vascular Surgery, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
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Li H, Li J, Zhan Y, Han Z, Liu F, Liang P, Yu X. Ultrasound-Guided 125I Seed Implantation in Treatment of Abdominal Wall Metastases. Cancer Biother Radiopharm 2019; 34:218-223. [PMID: 30810349 DOI: 10.1089/cbr.2018.2690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: The treatment of abdominal wall metastasis presents a challenge, because resection can be followed by poor healing and external radiotherapy is associated with serious adverse events. This study aimed to evaluate the efficacy and safety of interstitial 125I seed implantation under ultrasound (US) guidance for treating abdominal wall metastasis. Materials and Methods: The cases of 21 patients with 28 abdominal wall metastases who received brachytherapy with 125I seeds at the department from August 2010 to March 2015 were retrospectively reviewed. 125I seeds were implanted in the abdominal wall lesions under US guidance and with the help of a treatment planning system. Follow-up was performed using computed tomography at 1 d and at 3, 6, and 12 months after implantation. The lymphocyte count before the surgery was compared with the 3-month postoperative count. The main indicators observed were changes in tumor size, side effects, and complications. Results: All 21 patients were successfully treated with 125I seed implantation under US guidance. The median follow-up since 125I seed implantation was 15 months (range 6-23 months). The response rates and local tumor control after 3, 6, and 12 months were 78.6% and 89.3%, 64.3% and 85.7%, and 52.4% and 71.4%, respectively. The mean preoperative lymphocyte count was 0.262 ± 0.117 × 109/L, which did not differ significantly from the postoperative count, which was 0.259 ± 0.094 × 109/L (p = 0.122). Procedure-related complications included fever, bleeding, and pain, but all these were Grade 1-2. No severe side effects or complications were noted. Conclusions: Percutaneous interstitial implantation of 125I seeds under US guidance is safe and feasible for abdominal wall metastases. However, its long-term efficacy requires further investigation.
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Affiliation(s)
- Huarong Li
- 1 Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.,2 Department of Ultrasound, Aerospace Center Hospital, Beijing, China
| | - Jianming Li
- 3 Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yong Zhan
- 4 Department of Ultrasound, The 82nd Group Army Hospital, Baoding, Hebei, China
| | - Zhiyu Han
- 1 Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fangyi Liu
- 1 Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- 1 Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xiaoling Yu
- 1 Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
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Iodine-125 seeds in prostatic transurethral resection: Differential diagnosis with schistosome eggs. REVISTA ESPAÑOLA DE PATOLOGÍA : PUBLICACIÓN OFICIAL DE LA SOCIEDAD ESPAÑOLA DE ANATOMÍA PATOLÓGICA Y DE LA SOCIEDAD ESPAÑOLA DE CITOLOGÍA 2018; 52:54-56. [PMID: 30583833 DOI: 10.1016/j.patol.2018.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 01/26/2018] [Accepted: 02/08/2018] [Indexed: 11/22/2022]
Abstract
The presence of foreign bodies in a prostate transurethral resection may pose a histopathological challenge. A 65-year-old white man with urinary obstructive symptoms was subjected to a transurethral resection. Histopathology showed a squamous cell carcinoma affecting prostatic ducts and multiple foreign bodies; their differential diagnosis was between iodine-125 seeds and Schistosoma sp. eggs, as both can show oval morphology and terminal spines. The seeds are irregular, homogeneous and solid, unlike Schistosoma eggs that are heterogeneous, with a lytic appearance and some embryonated or calcified. The seeds are located in prostatic ducts inducing periductal fibrosis whereas the Schistosoma sp. eggs are found in the stroma inducing desmoplasia and granulomas. The seeds are associated with a lymphoplasmacytic infiltrate while the eggs are surrounded by eosinophils.
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Lu W, Du P, Yang C, Jiang F, Xie P, Yang J, Zhang Z, Ma J. The Effect of Computed Tomography-Guided 125I Radioactive Particle Implantation in Treating Cancer and Its Pain. Cancer Biother Radiopharm 2018; 33:176-181. [PMID: 29916744 DOI: 10.1089/cbr.2017.2425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND AIM Pain is a prevalent and serious problem in patients with cancer. This study aimed to investigate the clinical value of the implantation of radioactive particle 125I in treating cancer and its pain. MATERIALS AND METHODS From February 2014 to February 2015, 38 patients with malignant tumor received computed tomography (CT)-guided 125I radioactive particle implantation to treat cancer pain in this hospital. Before surgery, the lesions were calculated by brachytherapy treatment planning system (TPS) to get the local number of particles that are required for implantation. For a period after implantation, TPS was used again to assess the effect of treatment. The 38 patients received 6-month follow-up, and the CT scan was used to evaluate the local tumor. The visual analogue scale (VAS) was used to assess the pain. RESULTS The curative effect was evaluated at postoperative 2, 4, and 6 months, and the curative effect was 34.2%, 73.68%, and 89.47%, respectively. The preoperative VAS score of the 38 patients was 5.48 ± 2.50 (13 cases of mild pain, 19 cases of moderate pain, and 6 cases of severe pain), and their pain was improved in different degrees after operation. CONCLUSIONS CT-guided 125I radioactive particle implantation is a safe and effective treatment for cancer and its pain.
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Affiliation(s)
- Wei Lu
- Department of Interventional Radiology, Navy General Hospital , Beijing, China
| | - Peng Du
- Department of Interventional Radiology, Navy General Hospital , Beijing, China
| | - Chao Yang
- Department of Interventional Radiology, Navy General Hospital , Beijing, China
| | - Fuqiang Jiang
- Department of Interventional Radiology, Navy General Hospital , Beijing, China
| | - Peng Xie
- Department of Interventional Radiology, Navy General Hospital , Beijing, China
| | - Jian Yang
- Department of Interventional Radiology, Navy General Hospital , Beijing, China
| | - Zhe Zhang
- Department of Interventional Radiology, Navy General Hospital , Beijing, China
| | - Junpeng Ma
- Department of Interventional Radiology, Navy General Hospital , Beijing, China
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Wu C, Li B, Sun G, Peng C, Xiang D. Efficacy and safety of iodine-125 brachytherapy combined with chemotherapy in the treatment of advanced NSCLC in the elderly. Onco Targets Ther 2018; 11:6617-6624. [PMID: 30349295 PMCID: PMC6188210 DOI: 10.2147/ott.s174457] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Advanced non-small-cell lung cancer (NSCLC) is a huge challenge for physicians. Traditional chemoradiotherapy is associated with high rates of toxicities, especially when treating gerontal patients. Our study was focused on investigating the safety and efficacy of permanent iodine-125 seed implantation and chemotherapy for the treatment of advanced NSCLC in the elderly. Methods Fifty elderly patients with stage III or IV NSCLC at our hospital from January 2011 to June 2017 were treated with the chemotherapy regimens (paclitaxel/cisplatin) and computed tomography (CT)-guided iodine-125 brachytherapy (group A), 50 patients who received chemotherapy consisting of paclitaxel and cisplatin only (group B) were matched-up with the patients in group A. The local response rate was evaluated by CT. Progression-free survival (PFS) and overall survival (OS) data were obtained through clinical follow-up. Results The patients were followed-up for 3-46 months. With a median follow-up time of 20 months, the OS and PFS were 20 months (95% CI: 19.09-20.90 months) vs 15 months (95% CI: 14.48-15.51 months) (P<0.05) and 13 months (95% CI: 11.96-14.04 months) vs 8 months (95% CI: 7.63-8.37 months) (P<0.05) in group A and group B, respectively. The symptoms of patients in group A were significantly relieved when compared with group B. Severe complications were not observed in either of the groups. Conclusion The combination of iodine-125 seed brachytherapy and chemotherapy is an effective and safe therapy and is superior to chemotherapy alone for advanced NSCLC in the elderly.
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Affiliation(s)
- Chunrong Wu
- Department of Oncology, Jiangjin Center Hospital of Chongqing, Jiangjin, China,
| | - Bo Li
- Department of Cardiology, Jiangjin Center Hospital of Chongqing, Jiangjin, China
| | - Guiyin Sun
- Department of Oncology, Jiangjin Center Hospital of Chongqing, Jiangjin, China,
| | - Chunfang Peng
- Department of Oncology, Jiangjin Center Hospital of Chongqing, Jiangjin, China,
| | - Debing Xiang
- Department of Oncology, Jiangjin Center Hospital of Chongqing, Jiangjin, China,
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Design and development of microemulsion systems of a new antineoplaston A10 analog for enhanced intravenous antitumor activity: In vitro characterization, molecular docking, 125I-radiolabeling and in vivo biodistribution studies. Int J Pharm 2018; 545:240-253. [PMID: 29733973 DOI: 10.1016/j.ijpharm.2018.05.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/30/2018] [Accepted: 05/02/2018] [Indexed: 11/22/2022]
Abstract
A10, (3-phenylacetylamino-2,6-piperidinedione), is a natural peptide with broad antineoplastic activity. Recently, in vitro antitumor effect of a new A10 analog [3-(4-methoxybenzoylamino)-2,6-piperidinedione] (MPD) has been verified. However, poor aqueous solubility represents an obstacle towards intravenous formulation of MPD and impedes successful in vivo antitumor activity. To surmount such limitation, MPD microemulsion (MPDME) was developed. A 3122 full factorial design using Design-Expert® software was adopted to study the influence of different parameters and select the optimum formulation (MPDME1). Transmission electron microscopy (TEM) displayed spherical droplets of MPDME1. The cytotoxicity of MPDME1 in Michigan Cancer Foundation 7 (MCF-7) breast cancer cell line exceeded that of MPD solution (MPDS) and tamoxifen. Compatibility with injectable diluents, in vitro hemolytic studies and in vivo histopathological examination confirmed the safety of parenteral application of MPDME1. Molecular docking results showed almost same binding affinity of A10, MPD and 125I-MPD with histone deacetylase 8 (HDAC8) receptor. Accordingly, radioiodination of MPDME1 and MPDS was done via direct electrophilic substitution reaction. Biodistribution of 125I-MPDME1 and 125I-MPDS in normal and tumor (ascites and solid) bearing mice showed high accumulation of 125I-MPDME1 in tumor tissues. Overall, the results proved that MPDME represents promising parenteral delivery system capable of improving antineoplastic activity of MPD.
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Quality of life up to 10 years after external beam radiotherapy and/or brachytherapy for prostate cancer. Brachytherapy 2018; 17:517-523. [DOI: 10.1016/j.brachy.2018.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/15/2018] [Accepted: 01/18/2018] [Indexed: 11/23/2022]
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15
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Thomas L, Chemin A, Leduc N, Belhomme S, Rich E, Lasbareilles O, Giraud A, Descat E, Roubaud G, Sargos P. Manual vs. automated implantation of seeds in prostate brachytherapy: Oncologic results from a single-center study. Brachytherapy 2018; 17:214-220. [DOI: 10.1016/j.brachy.2017.09.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/20/2017] [Accepted: 09/26/2017] [Indexed: 11/29/2022]
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Maki S, Itoh Y, Kubota S, Okada T, Nakahara R, Ito J, Kawamura M, Naganawa S, Yoshino Y, Fujita T, Kato M, Gotoh M, Ikeda M. Clinical outcomes of 125I brachytherapy with and without external-beam radiation therapy for localized prostate cancer: results from 300 patients at a single institution in Japan. JOURNAL OF RADIATION RESEARCH 2017; 58:870-880. [PMID: 28992050 PMCID: PMC5737336 DOI: 10.1093/jrr/rrx051] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/11/2017] [Indexed: 06/07/2023]
Abstract
The aim of this study was to determine the outcomes and adverse events for 300 men with prostate cancer treated with 125iodine (125I) brachytherapy with and without external-beam radiation therapy (EBRT) at a single institution in Japan. Between February 2005 and November 2011, 300 consecutive patients with clinically localized prostate cancer were treated with 125I brachytherapy at the Nagoya University Hospital. A total of 271 men were treated with implants with doses of 145 Gy, and 29 men were treated with implants with doses of 110 Gy combined with EBRT (40-50 Gy/20-25 fractions). The median patient age was 69 years (range, 53-83 years). The median follow-up period was 53 months (range, 5-99 months). According to the National Comprehensive Cancer Network risk classification, 132 men (44%) had low-risk, 147 men (29%) had intermediate-risk and 21 men (7%) had high-risk disease. The 5-year overall survival rate, biochemical relapse-free survival rate, and disease-specific survival rates were 93.5%, 97.3% and 98.5%, respectively. Two men (0.6%) died of prostate cancer and 10 men (3.3%) died of other causes. Seventeen men (5.6%) experienced Grade 2 rectal bleeding in all: 12 (41.4%) of 29 in brachytherapy with EBRT, and 5 (1.8%) of 271 in brachytherapy alone. The rates of Grade 2 and 3 genitourinary toxicity were 1.0% and 1.7%, respectively. Excellent local control was achieved at our hospital for localized prostate cancer with 125I brachytherapy with and without EBRT. Gastrointestinal and genitourinary toxicities were acceptable.
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Affiliation(s)
- Sayo Maki
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
- Radiation and Proton Therapy Center, Nagaizumi, Shizuoka, Japan
| | - Yoshiyuki Itoh
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Seiji Kubota
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Tohru Okada
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Rie Nakahara
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Junji Ito
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Mariko Kawamura
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Shinji Naganawa
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yasushi Yoshino
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Takashi Fujita
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Masashi Kato
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Mitsuru Ikeda
- Department of Radiological Sciences, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Lin J, Yang W, Jiang N, Zheng Q, Huang J, Huang N, Li A, Jiang H. Incidence and prediction of seed migration to the chest after iodine-125 brachytherapy for hepatocellular carcinoma. Brachytherapy 2017; 16:1252-1256. [DOI: 10.1016/j.brachy.2017.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 06/30/2017] [Accepted: 07/11/2017] [Indexed: 01/09/2023]
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Low-dose-rate Brachytherapy for Prostate Cancer in Low-resource Settings. Int J Radiat Oncol Biol Phys 2017; 99:378-382. [PMID: 28871987 DOI: 10.1016/j.ijrobp.2017.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 04/03/2017] [Indexed: 11/23/2022]
Abstract
PURPOSE In areas with limited health care, it is important to identify and implement effective treatment methods and to optimize available resources. We investigated the implementation of a low-dose-rate (LDR) brachytherapy program for the treatment of prostate cancer (PCa) in a low-resource setting such as Puerto Rico (PR), where PCa is the main cause of cancer-associated death. METHODS AND MATERIALS After institutional approval, the medical records of patients with nonmetastatic PCa undergoing LDR brachytherapy from 2008 to 2013 were reviewed from PR. The factors analyzed included adequate D90 (radiation dose delivered to 90% of the target volume) coverage (≥140 Gy), early and late toxicity (Common Terminology Criteria for Adverse Events grade >2), and prostate-specific antigen failure. Freedom from biochemical failure was evaluated using Kaplan-Meier analysis. RESULTS The barriers to implementation of LDR brachytherapy in a country with limited resources were identified. These included lack of access to funding for startup costs, specific referral patterns, lack of trained support staff, such as dosimetrists and physicists, and initial opposition from insurance companies for reimbursement. The initial results from 191 patients were included in the present study with a median follow-up period of 26 months. Prostate-specific antigen failure occurred in 6 patients (3%). No early or late gastrointestinal toxicity (grade >2) developed. Only 3 (2%) and 2 (1%) patients experienced early and late genitourinary toxicity (grade >2), respectively. The 2- and 3-year freedom from biochemical failure in this population was 97% and 95.9%, respectively. CONCLUSIONS At present, limited data are available delineating the barriers faced by low-resource settings in the implementation of LDR brachytherapy. Our data highlight the issues unique to this environment and support the use of LDR brachytherapy as a reliable and effective treatment modality for patients with PCa in low-resource settings.
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Helou J, Torres S, Musunuru HB, Raphael J, Cheung P, Vesprini D, Chung HT, D'Alimonte L, Krahn M, Morton G, Loblaw A. Stereotactic Body Radiotherapy versus Low Dose Rate Brachytherapy for Localised Prostate Cancer: a Cost-Utility Analysis. Clin Oncol (R Coll Radiol) 2017; 29:718-731. [PMID: 28916284 DOI: 10.1016/j.clon.2017.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 07/23/2017] [Accepted: 07/24/2017] [Indexed: 12/14/2022]
Abstract
AIMS To conduct a cost-utility analysis comparing stereotactic body radiotherapy (SBRT) with low dose rate brachytherapy (LDR-BT) for localised prostate cancer (PCa). MATERIALS AND METHODS A decision-analytic Markov model was developed from the healthcare payer perspective to simulate the history of a 66-year-old man with low-risk PCa. The model followed patients yearly over their remaining lifetimes. Health states included 'recurrence-free', 'biochemical recurrence' (BR), 'metastatic' and 'death'. Transition probabilities were based on a retrospective cohort analysis undertaken at our institution. Utilities were derived from the literature. Costs were assigned in 2015 Canadian dollars ($) and reflected Ontario's health system and departmental costs. Outcomes included quality-adjusted life years (QALYs), costs and incremental cost-effectiveness ratios. A willingness-to-pay threshold of $50 000/QALY was used. RESULTS SBRT was the dominant strategy with 0.008LYs and 0.029QALYs gained and a reduction in cost of $2615. Under base case conditions, our results were sensitive to the BR probability associated with both strategies. LDR-BT becomes the preferred strategy if the BR with SBRT is 1.3*[baseline BR_SBRT] or if the BR with LDR-BT is 0.76*[baseline BR_LDR-BT]. When assuming the same BR for both strategies, LDR-BT becomes marginally more effective with 0.009QALYs gained at a cost of $272 848/QALY. CONCLUSIONS SBRT represents an economically attractive radiation strategy. Further research should be carried out to provide longer-term follow-up and high-quality evidence.
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Affiliation(s)
- J Helou
- Department of Radiation Oncology, University of Toronto, Toronto, Canada; Princess Margaret Cancer Centre, Toronto, Canada; Institute of Health Policy, Measurement and Evaluation, University of Toronto, Toronto, Canada.
| | - S Torres
- Institute of Health Policy, Measurement and Evaluation, University of Toronto, Toronto, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - H B Musunuru
- Department of Radiation Oncology, University of Toronto, Toronto, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - J Raphael
- Institute of Health Policy, Measurement and Evaluation, University of Toronto, Toronto, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - P Cheung
- Department of Radiation Oncology, University of Toronto, Toronto, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - D Vesprini
- Department of Radiation Oncology, University of Toronto, Toronto, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - H T Chung
- Department of Radiation Oncology, University of Toronto, Toronto, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - L D'Alimonte
- Department of Radiation Oncology, University of Toronto, Toronto, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - M Krahn
- Institute of Health Policy, Measurement and Evaluation, University of Toronto, Toronto, Canada; Toronto Health Economics and Technology Assessment Collaborative, Toronto, Canada
| | - G Morton
- Department of Radiation Oncology, University of Toronto, Toronto, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - A Loblaw
- Department of Radiation Oncology, University of Toronto, Toronto, Canada; Institute of Health Policy, Measurement and Evaluation, University of Toronto, Toronto, Canada; Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
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Freiberger C, Berneking V, Vögeli TA, Kirschner-Hermanns R, Eble MJ, Pinkawa M. Long-term prognostic significance of rising PSA levels following radiotherapy for localized prostate cancer - focus on overall survival. Radiat Oncol 2017; 12:98. [PMID: 28615058 PMCID: PMC5471896 DOI: 10.1186/s13014-017-0837-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 06/06/2017] [Indexed: 12/24/2022] Open
Abstract
Background The aim of this study was to evaluate the long-term prognostic significance of rising PSA levels, particularly focussing on overall survival. Methods Two hundred ninety-five patients with localized prostate cancer were either treated with low-dose-rate (LDR) brachytherapy with I-125 seeds as monotherapy (n = 94; 145Gy), high-dose-rate (HDR) brachytherapy with Ir-192 as a boost to external beam RT (n = 66; 50.4Gy in 1.8Gy fractions EBRT + 18Gy in 9Gy fractions HDR) or EBRT alone (70.2Gy in 1.8Gy fractions; n = 135). “PSA bounce” was defined as an increase of at least 0.2 ng/ml followed by spontaneous return to pre-bounce level or lower, biochemical failure was defined according to the Phoenix definition. Results Median follow-up after the end of radiotherapy was 108 months. A PSA bounce showed to be a significant factor for biochemical control (BC) and overall survival (OS) after ten years (BC10 of 83% with bounce vs. 34% without, p < 0.01; OS10 of 82% with bounce vs. 59% without bounce, p < 0.01). The occurrence of a bounce, a high nadir and the therapy modality (LDR-BT vs. EBRT and HDR-BT + EBRT vs. EBRT) proved to be independent factors for PSA recurrence in multivariate Cox regression analysis. A bounce was detected significantly earlier than a PSA recurrence (median 20 months vs. 32 months after RT; p < 0.01; median PSA doubling time 5.5 vs. 5.0 months, not significant). PSA doubling time was prognostically significant in case of PSA recurrence (OS10 of 72% vs. 36% with PSA doubling time ˃ 5 months vs. ≤ 5 months; p < 0.01). Conclusions Rising PSA levels within the first two years can usually be classified as a benign PSA bounce, with favourable recurrence-free and overall survival rates. PSA doubling time is an important predictor for overall survival following the diagnosis of a recurrence.
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Affiliation(s)
- Carla Freiberger
- Department of Radiation Oncology, RWTH Aachen University, Pauwelsstrasse 30, 52072, Aachen, Germany
| | - Vanessa Berneking
- Department of Radiation Oncology, RWTH Aachen University, Pauwelsstrasse 30, 52072, Aachen, Germany
| | | | - Ruth Kirschner-Hermanns
- Department of Urology/Neuro-Urology, Friedrich-Wilhelms-University Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany
| | - Michael J Eble
- Department of Radiation Oncology, RWTH Aachen University, Pauwelsstrasse 30, 52072, Aachen, Germany
| | - Michael Pinkawa
- Department of Radiation Oncology, RWTH Aachen University, Pauwelsstrasse 30, 52072, Aachen, Germany. .,Department of Radiation Oncology, MediClin Robert Janker Klinik, Villenstr. 8, 53129, Bonn, Germany.
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Dosimetric comparison between treatment plans of patients treated with low-dose-rate vs. high-dose-rate interstitial prostate brachytherapy as monotherapy: Initial findings of a randomized clinical trial. Brachytherapy 2017; 16:608-615. [DOI: 10.1016/j.brachy.2017.02.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 02/02/2017] [Accepted: 02/02/2017] [Indexed: 12/21/2022]
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Qian J, Bao Z, Zou J, Yang H. Effect of pedicle fixation combined with (125)I seed implantation for metastatic thoracolumbar tumors. J Pain Res 2016; 9:271-8. [PMID: 27274307 PMCID: PMC4869845 DOI: 10.2147/jpr.s105284] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Purpose The aim of this study was to investigate the clinical efficacy of pedicle fixation combined with 125I brachytherapy in treating metastatic thoracolumbar tumors. Patients and methods A retrospective analysis of the clinical data of seven metastatic thoracolumbar tumor patients who received pedicle fixation combined with radioactive 125I seed implantation brachytherapy in our department between January 2009 and December 2013 was performed. The visual analog scale (VAS) for pain and the Karnofsky performance status (KPS) score before the operation and 1, 6, and 12 months after the operation were observed and recorded. The changes in the scores at each time point were compared. Results All the patients underwent a successful operation, without any complications during their hospitalization. All the patients received postoperative follow-up, and the duration of follow-up was 15–50 months, with an average of 32.2 months. One pancreatic cancer patient died of liver failure and hypoproteinemia 28 months post surgery. The VAS scores of patients before the operation and 1, 6, and 12 months after the operation were 7.43±0.98, 2.71±0.49, 3.00±0.82, and 4.29±0.98, respectively; the KPS scores were 52.9±9.5, 84.3±5.3, 75.7±5.3, and 72.9±4.9, respectively. These results suggest that the VAS score at each time point was significantly decreased compared with that before the operation, while the KPS score was significantly increased compared with that before the operation. Both differences had statistical significance (P<0.05). Conclusion As a therapy for advanced malignant tumors with thoracolumbar metastasis, pedicle fixation combined with 125I brachytherapy can effectively relieve short-term pain and improve patient’s quality of life.
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Affiliation(s)
- Jiale Qian
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Zhaohua Bao
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Jun Zou
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Huilin Yang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
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Seed loss in prostate brachytherapy. Strahlenther Onkol 2016; 192:305-11. [DOI: 10.1007/s00066-016-0961-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 02/10/2016] [Indexed: 10/22/2022]
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