Predictive Factors for Acute and Late Urinary Toxicity After Permanent Prostate Brachytherapy: Long-Term Outcome in 712 Consecutive Patients

Keyes, Mira; Miller, Stacy; Moravan, Veronika; Pickles, Tom; McKenzie, Michael; Pai, Howard; Liu, Mitchell; Kwan, Winkle; Agranovich, Alexander; Spadinger, Ingrid; Lapointe, Vincent; Halperin, Ross; Morris, William

doi:10.1016/j.ijrobp.2008.05.022

Cited by 164 publications

(132 citation statements)

References 34 publications

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“…The AE data presented are similar to the data from a previously published HDR monotherapy series (11), which favorably compared with those from an LDR-BT series (12)(13)(14)(15). Zelefsky et al (16) reported that the 5 year likelihood of urethral stricture development was 10%, and the median duration until stricture development was 18 months.…”

Section: Discussionsupporting

confidence: 81%

Feasibility and early outcome of high-dose-rate Ir-192 brachytherapy as monotherapy in two fractions within 1 day for high-/very high-risk prostate cancer

Ashida

Yamasaki

Takagi

et al. 2016

Molecular and Clinical Oncology

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Abstract. The aim of the present study was to evaluate the feasibility and preliminary outcomes of high-dose-rate (HDR)-brachytherapy as a monotherapy in two fractions within 1 day for localized prostate cancer, including high-/very high-risk cases. Among the 68 patients treated with HDR monotherapy between July 2011 and December 2014, 65 had a minimal follow-up of 12 months without adjuvant androgen deprivation therapy and were enrolled in the present study [42/65 (64.6%) exhibited high-/very high-risk diseases]. HDR monotherapy was performed in two fractions with a minimal interval of 6 h and the prescribed dose was 13.5 Gy (x2). Adverse events (AEs) were assessed using Common Terminology Criteria for Adverse Events (version 4;

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Section: Discussionsupporting

confidence: 81%

Feasibility and early outcome of high-dose-rate Ir-192 brachytherapy as monotherapy in two fractions within 1 day for high-/very high-risk prostate cancer

Ashida

Yamasaki

Takagi

et al. 2016

Molecular and Clinical Oncology

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“…The reason may be due to the difference of PV. Keyes et al (2009) reported an incidence of AUT at RTOG Grade 3 of 16.2%. Their median of planning ultrasound-determined target volume was 38.0cm 3 (range, 17.0-67.2 cm 3 ).…”

Section: Discussionmentioning

confidence: 99%

“…Wust et al (2004) found that 14% of their patients required a catheter because of manifest retention and the PV was 34 ± 14 ml. In addition, according to Keyes et al (2009), a larger pre-implant PV increased the likelihood of acute RTOG Grade 3 toxicity. Our median of PV was 24.1 cm 3 and was smaller compared with previous studies, as summarized in Table 1.…”

Section: Discussionmentioning

confidence: 99%

Predicting the Severity of Acute Urinary Toxicity after Brachytherapy with Iodine-125 for Localized Prostate Cancer

Takeda

Jingu

Koto

et al. 2011

Tohoku J. Exp. Med.

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Prostate cancer is one of the common cancers in the world. In Japan, prostate brachytherapy (PB) with iodine-125 has become a treatment option for localized prostate cancer since 2003. Nevertheless, severe acute urinary toxicity (AUT) remains as one of the intractable side effects. We assessed AUT and the changes in international prostate symptom score (IPSS) before and after PB for localized prostate cancer. IPSS is a questionnaire tool for tracking the subjective urinary symptoms. Between 2006 and 2009, 104 eligible patients underwent PB with iodine-125 were analyzed. AUT was graded with the radiation therapy oncology group (RTOG) scale. Eligible patients filled out IPSS questionnaires before and after PB. Clinical and treatment-related factors were examined for correlation with the severity of AUT and the interval to IPSS resolution. AUT of RTOG Grade 0 (no changes) and Grade 2 was detected in one and 96 patients, respectively, whereas seven patients (6.7%) experienced AUT of Grade 3. Thus, the incidence of severe AUT (Grade 3) after PB was low. A greater number of needles ( p = 0.012) were associated with AUT of RTOG Grade 3 on the univariate analysis. The median interval to IPSS resolution was 6 months (7 ± 6 months). Greater post-implant maximal IPSS ( p < 0.001) was associated with slower IPSS resolution, whereas higher pre-implant IPSS ( p < 0.001) was associated with faster IPSS resolution on the multivariate analysis. In conclusion, reducing the number of needles in PB may be helpful for decreasing the rate of severe AUT.

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“…Eligible patients included those with low-risk disease (clinical stage VT 2a , initial prostate-specific antigen V10.0 ng/mL, and Gleason score V6) and "low tier" intermediate-risk patients (stage VT 2c and Gleason score V6 with initial prostate-specific antigen 10-15 ng/mL or Gleason score 7 with initial prostate-specific antigen <10 ng/mL). Our implant technique is described in detail elsewhere (3,4,6). Prostate and rectal dosimetry is obtained using day 30 postimplant CT using VariSeed software.…”

Section: Methodsmentioning

confidence: 99%

“…From our analysis of 1,000 brachytherapy patients with a minimum of 3 years of follow-up, patients with multiple severe toxicities are relatively rare, comprising 2% to 10% of the entire population. 4 For this study, an attempt was made to capture patients with the worse multiple toxicities, respecting the limitation of geographical availability, patient willingness to participate in the study, and self-imposed restrictions related to close to ideal post-implant dosimetry. As acute toxicity is likely related to the prostate brachytherapy procedure itself (4 -6, 9), this study is designed to account for late toxicity only, defined as a development of toxicity >1 year following the implant.…”

Section: Translational Relevancementioning

confidence: 99%

Sequence Variant Discovery in DNA Repair Genes from Radiosensitive and Radiotolerant Prostate Brachytherapy Patients

Pugh

Keyes

Barclay

et al. 2009

Clinical Cancer Research

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Purpose: The presence of intrinsic radiosensitivity within prostate cancer patients may be an important factor contributing to development of radiation toxicity. We investigated whether variants in genes responsible for detecting and repairing DNA damage independently contribute to toxicity following prostate brachytherapy. Experimental Design: Genomic DNA was extracted from blood samples of 41prostate brachytherapy patients, 21 with high and 20 with low late toxicity scores. For each patient, 242 PCR amplicons were generated containing 173 exons of eight candidate genes: ATM, BRCA1, ERCC2, H2AFX, LIG4, MDC1, MRE11A, and RAD50. These amplicons were sequenced and all sequence variants were subjected to statistical analysis to identify those associated with late radiation toxicity. Results: Across 41 patients, 239 sites differed from the human genome reference sequence; 170 of these corresponded to known polymorphisms. Sixty variants, 14 of them novel, affected protein coding regions and 43 of these were missense mutations. In our patient population, the high toxicity group was enriched for individuals with at least one LIG4 coding variant (P = 0.028). One synonymous variant in MDC1, rs28986317, was associated with increased radiosensitivity (P = 0.048). A missense variant in ATM, rs1800057, associated with increased prostate cancer risk, was found exclusively in two high toxicity patients but did not reach statistical significance for association with radiosensitivity (P = 0.488). Conclusions: Our data revealed new germ-line sequence variants, indicating that existing sequence databases do not fully represent the full extent of sequence variation. Variants in three DNA repair genes were linked to increased radiosensitivity but require validation in larger populations.

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Predictive Factors for Acute and Late Urinary Toxicity After Permanent Prostate Brachytherapy: Long-Term Outcome in 712 Consecutive Patients

Cited by 164 publications

References 34 publications

Feasibility and early outcome of high-dose-rate Ir-192 brachytherapy as monotherapy in two fractions within 1 day for high-/very high-risk prostate cancer

Feasibility and early outcome of high-dose-rate Ir-192 brachytherapy as monotherapy in two fractions within 1 day for high-/very high-risk prostate cancer

Predicting the Severity of Acute Urinary Toxicity after Brachytherapy with Iodine-125 for Localized Prostate Cancer

Sequence Variant Discovery in DNA Repair Genes from Radiosensitive and Radiotolerant Prostate Brachytherapy Patients

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