Prostate high dose-rate brachytherapy as monotherapy for low and intermediate risk prostate cancer: Efficacy results from a randomized phase II clinical trial of one fraction of 19 Gy or two fractions of 13.5 Gy.

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
Gerard MortonAndrew Loblaw

Abstract

High dose-rate (HDR) brachytherapy as monotherapy is a treatment option for localized prostate cancer, but optimal dose and fractionation is unknown. We report efficacy results of a randomized phase II trial of HDR monotherapy delivered as either one or two fractions. Eligible patients had low or intermediate risk prostate cancer, prostate volume <60 cc, and no androgen deprivation use. 170 patients were randomized to receive HDR as either a single fraction of 19 Gy or as two fractions of 13.5 Gy one week apart. Median age was 65 years, median PSA was 6.33 ng/ml, and Grade Group 1, 2 and 3 was present in 28%, 60%, and 12%, respectively. There was no difference in baseline factors between arms and 19%, 51% and 30% had low risk, favourable intermediate and unfavourable intermediate risk disease, respectively. The Phoenix definition was used to define biochemical failure, all local failures were confirmed by biopsy and toxicity was assessed using CTCAE v.4. Median follow-up was 60 months. PSA decreased more quickly in the 2-fraction arm (p = 0.009). Median PSA at 5-years was 0.65 ng/ml in the single fraction and 0.16 ng/ml in the 2-fraction arm. The 5-year biochemical disease-free survival and cumulative incidence of local failure...Continue Reading

Citations

Oct 2, 2020·International Journal of Impotence Research·Giuseppe FallaraAndrea Salonia
Sep 13, 2020·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Yasir AlayedGerard Morton
Jan 20, 2021·Brachytherapy·Gustavo Arruda VianiLigia Issa De Fendi
Jan 26, 2021·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Shreya ArmstrongPeter Hoskin
Dec 29, 2020·Clinical and Translational Radiation Oncology·Marieke van SonJochem van der Voort van Zyp
Jan 26, 2021·Advances in Radiation Oncology·Nicola J NasserAbed Agbarya
Dec 29, 2020·Frontiers in Oncology·Boris R ToccoAlison C Tree
Feb 23, 2021·Brachytherapy·Kevin Martell, Marisa A Kollmeier
Feb 28, 2021·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Yat Man TsangPeter J Hoskin
Dec 29, 2020·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Mark CorkumGerard Morton
Apr 23, 2021·Nature Reviews. Urology·Alison C Tree, Nicholas J van As
May 15, 2021·International Journal of Radiation Oncology, Biology, Physics·Jure Murgic, Hans T Chung
May 15, 2021·International Journal of Radiation Oncology, Biology, Physics·Marieke Juliet van SonJochem R N van der Voort van Zyp
Jul 24, 2021·Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]·Mohamed ShelanDaniel M Aebersold
Jul 28, 2021·Journal of Applied Clinical Medical Physics·Blake R SmithYusung Kim
Aug 5, 2021·International Journal of Radiation Oncology, Biology, Physics·Himanshu Nagar, Daniel E Spratt

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