Interstitial implantation techniques in prostate cancer

Sylvester, John; Blasko, John C.; Grimm, Peter; Ragde, Haakon

doi:10.1002/(sici)1096-9098(199709)66:1<65::aid-jso13>3.0.co;2-n

Cited by 74 publications

(18 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In Japan, BT using iodine-125 was performed transperineally, as previously described, 8 by a single radiation oncologist, accompanied by the referring urologist. The maximum prostate volume allowed was 45 cc, and men were excluded if they had undergone prior transurethral resection of prostate.…”

Section: Treatment Protocolsmentioning

confidence: 99%

Distress and social dysfunction following prostate cancer treatment: a longitudinal cross-cultural comparison of Japanese and American men

Namiki

Kwan

Kagawa‐Singer

et al. 2008

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

We assessed the impact of bother with urinary and bowel dysfunction on social activities among men in Japan and the United States following primary therapy for localized prostate cancer. In paired longitudinal outcomes studies, we measured general and disease-specific health-related quality of life in 400 Japanese and 427 American men who underwent radical prostatectomy or brachytherapy for localized prostate cancer. Outcomes included the social function domain of the Medical Outcomes Study Short Form-36 and the University of California, Los Angeles Prostate Cancer Index, all of which are scored 0-100. Participants completed the questionnaires before and 1, 12 and 24 months after treatment. Among men who reported any urinary bother, Japanese men had slightly better urinary function than American men (84 vs 77, Po0.01). Before brachytherapy, urinary bother was weakly correlated with social function in both the countries; after brachytherapy, urinary bother was strongly correlated with social function in American but not Japanese men. After brachytherapy, bowel dysfunction had a stronger correlation with social function in American than Japanese men (Po0.05). The bother associated with urinary and bowel dysfunction after surgery or brachytherapy for prostate cancer has a greater impact on social function in American men than in Japanese men.

show abstract

Section: Treatment Protocolsmentioning

confidence: 99%

Distress and social dysfunction following prostate cancer treatment: a longitudinal cross-cultural comparison of Japanese and American men

Namiki

Kwan

Kagawa‐Singer

et al. 2008

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

show abstract

“…One solution is to mark the urethra with a catheter. It is also possible to inject air containing gel or contrast media for marking the urethra (52).…”

Section: Problems Associated With Anatomymentioning

confidence: 99%

High dose-rate brachytherapy of prostate cancer utilising Iridium-192 after-loading technique: Technical and methodological aspects

Edgren

Ekelund²,

Albertsson³

et al. 2006

Int J Oncol

View full text Add to dashboard Cite

Abstract. The aim of this study was to focus on certain characteristic problems associated with Iridium-192 high dose-rate brachytherapy in combination with external beam radiation therapy (EBRT) in the treatment of patients with localised prostate cancer. Over a period of 16 years, >2,000 patients with prostate cancer have been treated in Sweden with a combination of two fractions of 10 Gy Ir-192 HDR-BT and 50 Gy of fractionated EBRT. Although this treatment is usually well tolerated, there are biological and technical factors to be considered before and during the treatment of the patient to avoid side effects or under-treatment of the target volume. Some of the problems facing the doctors are transducer stability, needle deviation, target definition, target motion, pubic arch interference, concomitant diseases and tolerance doses for different organs at risk. These problems are discussed and possible solutions are presented in this study. IntroductionProstate cancer is the most common malignancy afflicting Swedish men (1,2). Annually, more than 9,000 new cases are diagnosed (3). Although health controls have been ardently discussed during recent years, no screening programmes have as yet been initiated in Scandinavia (4,5). Radiotherapy and radical prostatectomy are generally regarded as the two chief modalities suitable for curative intent treatment (6-12). The results of treatment by these modalities are equivalent, but the acute and long-term side effects which develop after the definitive treatment of prostate cancer differ. The main side effects after surgery are impotence and incontinence, while proctitis, colitis and cystitis are seen after radiotherapy (13).The advantage of brachytherapy (BT) is the short irradiation range. This minimises the dose to organs at risk in the neighbourhood of the target, even though therapy requires that the irradiation source is placed inside or very near the target.Prostate BT was first reported by Pasteau in 1911 (14). The complication rate was high, probably due to the application of the source through the urethra. In the years that followed, the treatment of prostate cancer has focused on radical prostatectomy and external beam radiation therapy (EBRT). However, two different techniques for obtaining a more homogeneous dose distribution in the prostate, which reduce the frequency of side effects, were reported by Flocks in 1964 (15), by Carlton (16) and by Whitmore et al in 1972 (17). These techniques utilized permanent implants of low doserate (LDR) Gold-198 and Iodine-125 isotopes, respectively. These reports resulted in a renaissance for prostate BT. In 1977, Court and Chassangne (18) began treating prostate cancer with after-loading techniques, and since then several reports have been published (13,14,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). Although the data presented were encouraging, no randomised study has been published, and there are criticisms concerning some of the BT treatment studies (29,30). Randomised clinical trials are planned by national groups...

show abstract

“…All patients were treated with palladium-103 permanent interstitial implants to a prescribed dose of 90 Gy. Percutaneous transperineal implantation was carried out after the manner described by Sylvester et al 19 With the patient in dorsal lithotomy position under general anesthesia, the transrectal ultrasound with perineal implant template was carefully positioned to recreate the planning ultrasound. Transperineal 18 gauge preloaded needles were inserted into the prostate under ultrasonic guidance according to the previously generated plan.…”

Section: Brachytherapy Techniquesmentioning

confidence: 99%

Multimodality radiotherapy and androgen ablation in the treatment of clinically localized prostate cancer: early results in high risk patients

Coblentz

Bissonette

Williams

et al. 2002

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

In patients presenting with clinically localized prostate cancer, the risk of biochemical failure increases significantly with higher Gleason scores, prostate specific antigen (PSA) levels, and clinical stages. Current surgical and radiotherapeutic approaches appear to offer limited success in patients with highly adverse prognostic factors. In an attempt to improve on these outcomes, we have combined external beam radiotherapy (EBRT) with a brachytherapy (BT) boost and neo adjuvant and adjuvant androgen ablation in a population at significant risk of biochemical failure. Here we present early biochemical progression data for this approach. From October 1997 to July 1999, 72 men with a serum PSA 10 ng/ml or Gleason score 7 or clinical stage T2c (AJC/UICC 1992) underwent EBRT followed by palladium-103 BT. All patients underwent 8 months of combined androgen ablation with leuprolide and an oral antiandrogen beginning 3 months prior to initiation of EBRT. Patients were followed by PSA and digital rectal examination (DRE) at 3-month intervals and a chart review on all patients was carried out during July 2001. To allow comparisons to contemporary literature, Kaplan-Meier survival curves were generated utilizing three alternate definitions of biochemical recurrence: PSA > 0.2 ng/ml, PSA > 1.0 ng/ml, and the American Society for Therapeutic Radiology and Oncology (ASTRO) consensus definition of three consecutive rising PSAs. Our results indicate that when PSA > 0.2 ng/ml was used to define biochemical progression, 88% (95% CI 80 -97) of patients remained free of disease at 24 months. When PSA > 1.0 ng/ml was used, 97% (CI 92 -100) of patients remained disease free at 24 months. ASTRO criteria yielded 90% (CI 82 -98) recurrence-free survival at 24 months. In conclusion, this very early report indicates that in patients who are at increased risk of biochemical failure, EBRT with a BT boost in conjunction with short-term androgen ablation offers potentially superior biochemical disease-free survival to contemporary alternative approaches in the literature. Clearly, longer followup is required to confirm the durability of this approach.

show abstract

Interstitial implantation techniques in prostate cancer

Cited by 74 publications

References 53 publications

Distress and social dysfunction following prostate cancer treatment: a longitudinal cross-cultural comparison of Japanese and American men

Distress and social dysfunction following prostate cancer treatment: a longitudinal cross-cultural comparison of Japanese and American men

High dose-rate brachytherapy of prostate cancer utilising Iridium-192 after-loading technique: Technical and methodological aspects

Multimodality radiotherapy and androgen ablation in the treatment of clinically localized prostate cancer: early results in high risk patients

Contact Info

Product

Resources

About