Salvage low dose rate brachytherapy for prostate cancer recurrence following definitive external beam radiation therapy

Smith, William H.; Cesaretti, Jamie A.; Chin, Chih Peng; Terk, Mitchell; Stock, Richard G.

doi:10.1016/j.radonc.2020.10.021

Cited by 9 publications

(9 citation statements)

References 25 publications

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“…Other treatment modalities have been evaluated as salvage treatment for intraprostatic recurrences. In particular, brachytherapy, whether in HDR, 25 LDR, 26 or PDR 27 with good results, but the logistics and skills required for its implementation could be an obstacle in routine clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Salvage stereotactic reirradiation for intraprostatic cancer recurrence: A large retrospective study

et al. 2023

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Introduction: Prostate cancer is the most common cancer in men. Thirty to forty-seven percent of patients treated with exclusive radiotherapy for prostate cancer will experience intraprostate recurrence. The use of radiotherapy in stereotactic conditions allows millimetric accuracy in irradiation to the target zone that minimizes the dose to organs at risk. In this study, we evaluated the clinical outcome of prostatic reirradiation with stereotactic body radiation therapy (SBRT) in patients with intraprostatic recurrence initially treated by radiotherapy.Method: This single-center retrospective study included 41 patients diagnosed with exclusive local recurrence of prostate cancer after radiotherapy and treatedby stereotactic Cyberknife irradiation. The objective of this study was to assess the efficacy and the safety of stereotactic reirradiation for patients with intraprostatic recurrence initially treated with radiotherapy.Results: Median follow-up was 35 months. The 2-year biochemical relapse-free survival was 72.89%, the 2-year local recurrence free survival was 93.59%, the 2-year local regional recurrence-free survival was 85.24%, and the 2-year metastasis-free survival was to 91.49%. The analysis of toxicities showed a good tolerance of stereotactic irradiation. Urinary and gastro-intestinal adverse events was mostly of grades 1-2 (CTCAEv4). Grade 3 toxicity occurred in one to two patients. Conclusion:Stereotactic reirradiation appears effective and well-tolerated for local recurrence of prostate cancer and might allow to delay the introduction of hormonal therapy and its side effects.

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Section: Discussionmentioning

confidence: 99%

Salvage stereotactic reirradiation for intraprostatic cancer recurrence: A large retrospective study

et al. 2023

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“…DRPs and pharmacist interventions data within the dataset were then coded using a validated framework for categorizing pharmaceutical care activities contributing to reducing patient harm associated with detecting DRPs and resolving them ( Schaefer, 2002 ). Severity of AEs was assessed by the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 as Grade 1 to 5 which was widely used in previous studies ( Common Terminology Criter, 2017 ; Smith et al, 2021 ). Severity of drug-drug interactions was evaluated with Lexi-Interact online ( Lexicomp.…”

Section: Methodsmentioning

confidence: 99%

“…(Schaefer, 2002). Severity of AEs was assessed by the Common Terminology Criteria for Adverse Events (CTCAE) v5.0 as Grade 1 to 5 which was widely used in previous studies (Common Terminology Criter, 2017;Smith et al, 2021). Severity of drug-drug interactions was evaluated with Lexi-Interact online (Lexicomp.…”

Section: Overview Of Study Designmentioning

confidence: 99%

Impact of a Collaborative Pharmaceutical Care Service for Patients With Parkinson’s Disease

et al. 2022

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Objective: To identify the impact of a collaborative pharmaceutical care service (CPCS) on medication safety and establish the impact of the CPCS on patient reported outcomes for Parkinson’s disease (PD) patients.Methods: Initially, PD outpatients receiving the CPCS between March 2017 and March 2019 were compared with PD patients receiving standard of care to identify differences in management. Pharmacist interventions data were coded and patients with PD receiving the CPCS were compared with those receiving standard of care to determine differences in medicines prescribed and dosage associated with these. Following this, data of patients receiving CPCS at baseline and 3-months follow-up were collected using a questionnaire consisting of validated measures of two patient-reported outcomes [adherence and quality of life (QoL)]. Mean scores for continuous variables were calculated, with descriptive analysis of categorical variables consisting of frequency counts and percentages. Change in adherence score before and after CPCS was investigated using a Wilcoxon sign rank sum test, spearman correlation analysis was used to correlate the changes in QoL before and after CPCS with the number of interventions, and p < 0.05 indicates that the difference is statistically significant.Results: A total of 331 PD outpatients received CPCS over 490 outpatient visits with an average age of 71.83 (±12.54). Five hundred and forty-five drug related problems were recorded as pharmacist interventions, of which most involved change to dosage (n = 226, 41.47%), adverse drug reactions (n = 135, 24.77%), and change in a medication (n = 102, 18.72%). Compared with those receiving standard of care, patients receiving CPCS were significantly less likely to have been prescribed pramipexole (18.52 versus 23.77%, p < 0.001) and more likely to have been prescribed amantadine (5.40 versus 3.70%, p = 0.02) and selegiline (17.36 versus 11.64%, p < 0.001). Lower dosages of levodopa/benserazide (0.51 ± 0.31 g versus 0.84 ± 0.37 g, p < 0.001), levodopa/carbidopa (0.33 ± 0.23 g versus 0.66 ± 0.47 g, p < 0.001), pramipexole (1.14 ± 1.63 mg versus 1.27 ± 0.69 mg, p = 0.01), and entacapone (130.00 ± 79.76 mg versus 173.09 ± 97.86 mg, p < 0.001) were also recorded. At baseline 119 PD outpatients with an average age of 69.98 (±9.90) were recruited for the longitudinal study. At 3-month follow-up, participants reported improvement in bodily pain subscale (baseline versus 3-months follow-up, 30.04 ± 22.21 versus 23.01 ± 20.98, p = 0.037) and medication adherence (6.19 ± 1.50 versus 6.72 ± 1.73, p = 0.014). Frequency of CPCS use was related to activity of daily living subscale (p = 0.047), the bodily pain subscale (p = 0.026), and medication adherence (p = 0.011). Total score of PDQ-39 was associated with patient education (p = 0.005) and usage and dosage combined with patient education (p = 0.006), while medication adherence score was associated with usage and dosage (p = 0.005).Conclusion: The CPCS was effective in resolving drug-related problems and in improving patients’ medication regimens, medication adherence, and QoL through patient education and dosage adjustments. This is the first step in the development and feasibility testing of pharmacy services for PD patients in China.

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“…They also revealed the 17-year BFFS (86%, 80%, and 65%, p < 0.001) and OS (82%, 73%, and 60%, p = 0.09) rate for low-, intermediate-, and high-risk patients ( 150 ). Another study also reported the 10-year actuarial freedom from biochemical failure (FFbF) (52.0%), PCaSS (77.8%), and OS (56.7%) in patients who underwent salvage LDR-BT for biopsy-confirmed intra-prostatic recurrence after EBRT ( 151 ). Placement of hydrogel space between prostate and rectum immediately after I-125 implantation for prostate cancer significantly reduced RV150 and RV100, without impact on prostate V100 and V150, which had the potential to reduce late GI toxicity and improve bowel function ( 152 ).…”

Section: I-125 Brachytherapy In Solid Tumorsmentioning

confidence: 97%

Radioactive Iodine-125 in Tumor Therapy: Advances and Future Directions

Wei

Mengyuan

et al. 2021

Front. Oncol.

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Radioactive iodine-125 (I-125) is the most widely used radioactive sealed source for interstitial permanent brachytherapy (BT). BT has the exceptional ability to deliver extremely high doses that external beam radiotherapy (EBRT) could never achieve within treated lesions, with the added benefit that doses drop off rapidly outside the target lesion by minimizing the exposure of uninvolved surrounding normal tissue. Spurred by multiple biological and technological advances, BT application has experienced substantial alteration over the past few decades. The procedure of I-125 radioactive seed implantation evolved from ultrasound guidance to computed tomography guidance. Compellingly, the creative introduction of 3D-printed individual templates, BT treatment planning systems, and artificial intelligence navigator systems remarkably increased the accuracy of I-125 BT and individualized I-125 ablative radiotherapy. Of note, utilizing I-125 to treat carcinoma in hollow cavity organs was enabled by the utility of self-expandable metal stents (SEMSs). Initially, I-125 BT was only used in the treatment of rare tumors. However, an increasing number of clinical trials upheld the efficacy and safety of I-125 BT in almost all tumors. Therefore, this study aims to summarize the recent advances of I-125 BT in cancer therapy, which cover experimental research to clinical investigations, including the development of novel techniques. This review also raises unanswered questions that may prompt future clinical trials and experimental work.

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Salvage low dose rate brachytherapy for prostate cancer recurrence following definitive external beam radiation therapy

Cited by 9 publications

References 25 publications

Salvage stereotactic reirradiation for intraprostatic cancer recurrence: A large retrospective study

Salvage stereotactic reirradiation for intraprostatic cancer recurrence: A large retrospective study

Impact of a Collaborative Pharmaceutical Care Service for Patients With Parkinson’s Disease

Radioactive Iodine-125 in Tumor Therapy: Advances and Future Directions

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