Long-Term (10-Year) Gastrointestinal and Genitourinary Toxicity after Treatment with External Beam Radiotherapy, Radical Prostatectomy, or Brachytherapy for Prostate Cancer

Hunter, G.K.; Reddy, C.A.; Klein, Eric A.; Kupelian, Patrick A.; Angermeier, Kenneth W.; Ulchaker, James; Chehade, Nabil El Hage; Altman, Andrew; Ciezki, Jay P.

doi:10.1155/2012/853487

Cited by 39 publications

(18 citation statements)

References 29 publications

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“…Our rate of late GI toxicity is lower than what we have previously reported for EBRT (36) and is lower than that reported in series with combination therapy (8,29). The majority of our grade !3 toxicities were due to cauterization of PI-related rectal bleeding.…”

Section: Gi Toxicity Analysiscontrasting

confidence: 68%

Long-Term Efficacy and Toxicity of Low-Dose-Rate 125 I Prostate Brachytherapy as Monotherapy in Low-, Intermediate-, and High-Risk Prostate Cancer

Kittel

Reddy

Smith

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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Section: Gi Toxicity Analysiscontrasting

confidence: 68%

Long-Term Efficacy and Toxicity of Low-Dose-Rate 125 I Prostate Brachytherapy as Monotherapy in Low-, Intermediate-, and High-Risk Prostate Cancer

Kittel

Reddy

Smith

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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“…Processes taking place in other systems and organs may also have an effect on oxidant-antioxidant balance as therapy side effects. It has been demonstrated, for example, that toxic effects in the gastrointestinal and genitourinary tract may remain for about 10 years after brachytherapy, external beam radiotherapy, or radical prostatectomy [19]. …”

Section: Discussionmentioning

confidence: 99%

Oxidative Stress Markers in Prostate Cancer Patients after HDR Brachytherapy Combined with External Beam Radiation

Woźniak

Masiak

Szpinda

et al. 2012

Oxidative Medicine and Cellular Longevity

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Assessment of oxidative stress markers was perfomed in prostate cancer (PCa) patients subjected to high-dose brachytherapy (HDR) with external beam radiotherapy (EBRT). Sixty men with PCa were subjected to combined two-fraction treatment with HDR (tot. 20 Gy) and EBRT (46 Gy). Blood samples were taken before treatment, immediately afterwards, after 1.5–3 months, and approx. 2 years. Control group consisted of 30 healthy men. Erythrocyte glutathione peroxidase activity in the patients was lower than in healthy subjects by 34% (P < 0.001), 50% (P < 0.001), 30% (P < 0.05), and 61% (P < 0.001), respectively, at all periods. No significant differences were found by comparing superoxide dismutase and catalase activity in PCa patients with that of the controls. After 2 years of the end of treatment, the activity of studied enzymes demonstrated a decreasing tendency versus before therapy. Blood plasma thiobarbituric acid reactive substances (TBARS) concentration was higher than in the controls at all periods, while erythrocyte TBARS decreased after 2 years to control levels. The results confirm that in the course of PCa, imbalance of oxidant-antioxidant processes occurs. The therapy did not alter the levels of oxidative stress markers, which may prove its applicability. Two years is too short a period to restore the oxidant-antioxidant balance.

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“…6,12,13 Clinical parameters were also explored for their effects on treatment outcomes, including disease staging, prescribed dose, dosimetric values for tumor and organs at risk volumes, and total treatment duration. [13][14][15][16][17] These clinical and pathological prognostic factors have been studied extensively and deemed important for prediction of survival outcomes. Despite optimizing treatments based on these factors, the recurrence rates remain among 30-40% in patients having locally advanced cervical cancer.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Indicators for Treatment Outcome in Cervical Cancer: A Mini Review

Zhuang

Meerschaert

2016

IJRRT

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Abbreviations: RT, radiotherapy; CCRT, concomitant chemoradiotherapy; BT, brachytherapy; PET, positron emission tomography; SUV, standard uptake value; MTV, metabolic tumor volume; TGV, tumor glycolytic volume IntroductionOver 50years ago, the Papanicolaou (Pap) smear was introduced in the US which has resulted in significant declines in cervical cancer incidences and deaths. However, cervical cancer remains the third most prevalent cancer in females worldwide.1,2 At advanced stages of the disease, treatment with radiotherapy (RT) alone decreases 5year survival rates leading to the implementation of multiple randomized clinical studies.3 Advancements found that combining chemotherapy and RT resulted in increased progression-free and overall survival with improved local control.3-5 As a result, in 1999 the US National Cancer Institute announced concomitant chemotherapy and RT (CCRT) as the standard of care for cervical cancer. 4,6 Since the acceptance of CCRT, the most significant advancement in treatment of cervical cancer over the last 20years has been brachytherapy (BT), which further improved survival rates.5 Dose and fractionation determination have been improved due to greater understanding of tumor biology and radiation effects, but remain limited by tolerance of normal tissue for late effects and therefore also limiting the cure rate.3,5 While CCRT involving BT advanced treatment outcomes, the improved survival rates have come at the cost of increased acute and late toxicity rates. 4,6 The current standard of care for locally advanced cervical cancer is a combination of external beam radiotherapy and intracavitary BT with concurrent chemotherapy. High dose rate BT is an important component in the curative management of cervix carcinoma and is most commonly delivered in five fractions using tandem&ring or tandem&ovoids applicators.7 Despite advanced treatment plans, treatment-related toxicity and recurrence still occur in a significant number of patients after treatment due to chemotherapy agents increasing radiosensitivity and ultimately the radiation hazard. 8,9 Although local control and toxicity rates have been slightly improving, recurrence rates remain as high as one-third, and toxicity rates remain as high as one-half among cervical cancer patients.10,11 Therefore, it has been of great clinical importance to investigate early indicators for optimal therapeutic response based on which treatments can be adjusted to minimize recurrence or toxicity outcomes. Once prognostic factors are identified, the aggressiveness of treatment can be properly determined. The current mini-review provides a summary of toxicity and recurrence outcomes, in addition to both clinical and biological indicators for improved treatment outcomes of cervical cancer patients. DiscussionRandomized studies of locally advanced cervical cancer patients showed CCRT improves long-term survival when compared to RT alone, though concurrent treatments result in more frequent acute toxicity and a 5% chance of late stage pelvic complications...

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Long-Term (10-Year) Gastrointestinal and Genitourinary Toxicity after Treatment with External Beam Radiotherapy, Radical Prostatectomy, or Brachytherapy for Prostate Cancer

Cited by 39 publications

References 29 publications

Long-Term Efficacy and Toxicity of Low-Dose-Rate 125 I Prostate Brachytherapy as Monotherapy in Low-, Intermediate-, and High-Risk Prostate Cancer

Long-Term Efficacy and Toxicity of Low-Dose-Rate 125 I Prostate Brachytherapy as Monotherapy in Low-, Intermediate-, and High-Risk Prostate Cancer

Oxidative Stress Markers in Prostate Cancer Patients after HDR Brachytherapy Combined with External Beam Radiation

Prognostic Indicators for Treatment Outcome in Cervical Cancer: A Mini Review

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