Rates of rectal toxicity in patients treated with high dose rate brachytherapy as monotherapy compared to dose-escalated external beam radiation therapy for localized prostate cancer

Parzen, Jacob S; Ye, Hong; Gustafson, Gary; Yan, Di; Martínez, Álvaro; Chen, Peter Y.; Ghilezan, Michel; Sebastian, Evelyn; Limbacher, Amy; Krauss, Daniel

doi:10.1016/j.radonc.2020.03.033

Cited by 10 publications

(4 citation statements)

References 29 publications

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“…Therefore, it could be argued that HDR should result in an even more substantial reduction in the rate of rectal toxicity than proton therapy, and recently published retrospective evidence has suggested just that. 26 …”

Section: Discussionmentioning

confidence: 99%

Normal Tissue Integral Dose as a Result of Prostate Radiation Therapy: A Quantitative Comparison Between High-Dose-Rate Brachytherapy and Modern External Beam Radiation Therapy Techniques

Grzywacz

Arden

Mankuzhy³

et al. 2023

Advances in Radiation Oncology

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Section: Discussionmentioning

confidence: 99%

Normal Tissue Integral Dose as a Result of Prostate Radiation Therapy: A Quantitative Comparison Between High-Dose-Rate Brachytherapy and Modern External Beam Radiation Therapy Techniques

Grzywacz

Arden

Mankuzhy³

et al. 2023

Advances in Radiation Oncology

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“…Literature analysis clearly demonstrated that these differences transformed into important clinical consequences. For instance, it was shown that low and high dose rate brachytherapy was associated with significant reduction of grade III rectal toxicity when compared to external beam radiotherapy [ 4 , 20 , 21 ], SBRT [ 22 ] as monotherapy treatment and SBRT as a boost [ 18 , 23 ]. It is interesting that in all of these studies brachytherapy manifested by maximum grade II rectal toxicity that matches our data.…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, grade III rectal late toxicity varied in most of these studies around 2.5%-5% [ 4 , 18 , 22 , 23 ]. Parzen et al [ 21 ] analyzed rectal toxicity in 2,863 patients with prostate cancer and mentioned that compared to external beam radiotherapy HDRB was associated with the decreased rates of chronic rectal grade ≥ II bleeding (1.3% vs. 8.7%).…”

Section: Discussionmentioning

confidence: 99%

A comparison between high dose rate brachytherapy and stereotactic body radiotherapy boost after elective pelvic irradiation for high and very high-risk prostate cancer

Новиков¹,

Novikov²,

Merezhko³

et al. 2022

Radiat Oncol J

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Purpose: To compare biochemical recurrence-free survival (BRFS) and toxicity outcomes of high dose rate brachytherapy (HDRB) and stereotactic body radiotherapy (SBRT) boost after elective nodal irradiation for high/very high-risk prostate cancer.Materials and Methods: a retrospective analysis was performed in 149 male. In 98 patients, the boost to the prostate was delivered by HDRB as 2 fractions of 10 Gy (EQD2 for α/β = 1.5; 66 Gy) or 1 fraction of 15 Gy (EQD2 for α/β = 1.5; 71 Gy). In 51 male, SBRT was used for the boost delivery (3 fractions of 7 Gy; EQD2Gy for α/β = 1.5; 51 Gy) because brachytherapy equipment was out of order.Results: In 98 patients that received HDRB boost, 3- and 5-year BRFS were 74.6% and 66.8%. Late grade-II genitourinary toxicity was detected in 27, grade-III in 1 case. Grade-II (maximum) rectal toxicity was diagnosed in nine patients. For 51 male patients that received SBRT boost, 3- and 5-year BRFS was 76.5% and 67.7%. Late grade-II (maximum) genitourinary toxicity was detected in five cases, late grade-II rectal toxicity in four cases. Other three patients developed late grade-III–IV rectal toxicity that required diverting colostomy. SBRT boost was associated with higher maximum dose to 2 cm3 of anterior rectal wall (D2cm³rectum) compared to HDRB: 92% versus 55% of dose to prostate. Severe rectal toxicity was negligible at EQD2 D2cm³rectum <85 Gy and EQD2 D5cm³ rectum <75 Gy.Conclusion: Our results indicate similar 3- and 5-year BRFS in patients with high/very high-risk prostate cancer who received HDRB or SBRT boost, but SBRT boost is associated with higher rate of severe late rectal toxicity.

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“…Statistical significance was subsequently achieved for prostate cancer patients verified with cone beam Kv CT (CBKvCT) versus those verified with electronic portal devices (EPIDs) in the work of Conde-Moreno et al (20). The irreplaceability of a live IGRT lies in the demonstrated inadequacy of an off-line adaptive process used to define a PTV depending on variation in prostate position: indeed, Parzen et al found a significantly higher rate of rectal toxicity among patients treated with an Image-Guided Adaptive Radiation Therapy, compared to those treated with BT (21). The ultimate achievement of the IGRT potential derives from works such as those of D'Agostino et al (22), who published acceptable rectal toxicity rates (<20%) in patients with prostate cancer treated with ultrahyprofractionated VMAT and Real-time Electromagnetic Tracking.…”

Section: Literature Overviewmentioning

confidence: 99%

A Ten-year-long Update on Radiation Proctitis Among Prostate Cancer Patients Treated With Curative External Beam Radiotherapy

Ferini¹,

Pergolizzi

2021

In Vivo

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This comprehensive synopsis summarizes the most relevant information obtained from a systematic analysis of studies of the last decade on radiation proctitis, one of the most feared radioinduced side effects among prostate cancer patients treated with curative external beam radiotherapy. The present review provides a useful support to radiation oncologists for limiting the onset or improving the treatment of radiation proctitis. This work shows that the past decade was a harbinger of significant new evidence in technological advances and technical tricks to avoid radiation proctitis, in addition to dosimetric perspectives and goals, understanding of pathogenesis, diagnostic work-up and treatment. We believe that a well-rounded knowledge of such an issue is fundamental for its appropriate management.

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Rates of rectal toxicity in patients treated with high dose rate brachytherapy as monotherapy compared to dose-escalated external beam radiation therapy for localized prostate cancer

Cited by 10 publications

References 29 publications

Normal Tissue Integral Dose as a Result of Prostate Radiation Therapy: A Quantitative Comparison Between High-Dose-Rate Brachytherapy and Modern External Beam Radiation Therapy Techniques

Normal Tissue Integral Dose as a Result of Prostate Radiation Therapy: A Quantitative Comparison Between High-Dose-Rate Brachytherapy and Modern External Beam Radiation Therapy Techniques

A comparison between high dose rate brachytherapy and stereotactic body radiotherapy boost after elective pelvic irradiation for high and very high-risk prostate cancer

A Ten-year-long Update on Radiation Proctitis Among Prostate Cancer Patients Treated With Curative External Beam Radiotherapy

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