Salvage prostate HDR brachytherapy combined with interstitial hyperthermia for local recurrence after radiation therapy failure

Kukielka, A.; Hetnał, Marcin; Dąbrowski, Tomasz; Walasek, Tomasz; Brandys, Piotr; Nahajowski, D.; Kudzia, R.; Dybek, D.; Reinfuss, Marian

doi:10.1007/s00066-013-0486-z

Cited by 30 publications

(17 citation statements)

References 21 publications

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“…Both temporary implants (Ir-192) and permanent implants (I-125, Pd-103) have been used for treatment of prostate cancer recurrence after EBRT. There are few available publications on HDRBT or PDRBT; most of them are retrospective studies that apply to small groups of patients [ 10 – 16 ]. The results and toxicity are summarized in the Table 1 .…”

Section: Purposementioning

confidence: 99%

Educational article Salvage brachytherapy in combination with interstitial hyperthermia for locally recurrent prostate carcinoma following external beam radiation therapy: a prospective phase II study

Kukielka¹,

Strnad²,

Stauffer³

et al. 2015

jcb

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Optimal treatment for patients with only local prostate cancer recurrence after external beam radiation therapy (EBRT) failure remains unclear. Possible curative treatments are radical prostatectomy, cryosurgery, and brachytherapy. Several single institution series proved that high-dose-rate brachytherapy (HDRBT) and pulsed-dose-rate brachytherapy (PDRBT) are reasonable options for this group of patients with acceptable levels of genitourinary and gastrointestinal toxicity. A standard dose prescription and scheme have not been established yet, and the literature presents a wide range of fractionation protocols. Furthermore, hyperthermia has shown the potential to enhance the efficacy of re-irradiation.Consequently, a prospective trial is urgently needed to attain clear structured prospective data regarding the efficacy of salvage brachytherapy with adjuvant hyperthermia for locally recurrent prostate cancer. The purpose of this report is to introduce a new prospective phase II trial that would meet this need. The primary aim of this prospective phase II study combining Iridium-192 brachytherapy with interstitial hyperthermia (IHT) is to analyze toxicity of the combined treatment; a secondary aim is to define the efficacy (bNED, DFS, OS) of salvage brachytherapy. The dose prescribed to PTV will be 30 Gy in 3 fractions for HDRBT, and 60 Gy in 2 fractions for PDRBT. During IHT, the prostate will be heated to the range of 40–47°C for 60 minutes prior to brachytherapy dose delivery. The protocol plans for treatment of 77 patients.

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Section: Purposementioning

confidence: 99%

Educational article Salvage brachytherapy in combination with interstitial hyperthermia for locally recurrent prostate carcinoma following external beam radiation therapy: a prospective phase II study

Kukielka¹,

Strnad²,

Stauffer³

et al. 2015

jcb

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show abstract

“…Likewise, reports of complications associated with HDRBT þ IHT are scarce. The group of patients which we analysed in two earlier articles published in 2013 and 2014 [17,18] largely overlaps with the patient group analysed in this work, thus obviating any comparative effort.…”

Section: Evaluation Of Early Hdrbt 1 Iht Complicationsmentioning

confidence: 99%

“…So far, no randomised phase III studies of prostate cancer treated with hyperthermia have been conducted. Most of the available publications concerning phase I and II studies refer to deep hyperthermia [2,[11][12][13]15] and transrectal hyperthermia [16], with only a few studies on interstitial hyperthermia [17][18][19][20].…”

Section: Purposementioning

confidence: 99%

Evaluation of tolerance and toxicity of high-dose-rate brachytherapy boost combined with interstitial hyperthermia for prostate cancer

Kukielka

Hetnał²,

Bereza

2016

International Journal of Hyperthermia

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Purpose The aim of this retrospective study was to evaluate the tolerance and early as well as late toxicity of high dose rate brachytherapy (HDRBT) boost combined with interstitial hyperthermia (IHT) in patients treated for prostate cancer. Material and methods Between January 2011 and June 2013 76 patients diagnosed with prostate cancer received treatment consisting of external beam radiotherapy (EBRT), followed by a HDRBT boost combined with IHT. IHT was performed before each brachytherapy fraction. Results The median follow-up time was 26.3 months (range 7-43 months). Early genitourinary (GU) grade 1 and 2 toxicities were common, but only two patients (2.6%) experienced acute urinary retention requiring temporary catheterisation (grade 2 toxicity). No grade 3 or 4 genitourinary or gastrointestinal toxicities were observed. In the group analysed, 59 of 76 patients had follow-up times longer than 18 months. The incidence of grade 2 late toxicity in the group studied did not exceed 23.7%. There were no late grade 2 or higher complications from the gastrointestinal tract. Conclusions The tolerance of HDRBT boost combined with IHT is good. The profile and the percentage of early and late complications are acceptable.

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“…One possible way of achieving this is by applying hyperthermia, an increase of temperature above 37°C. This treatment sensitizes cells to radiotherapy and is being validated in clinical setting now [82,83]. The mechanism depends in part on inhibition of DSB repair, especially HR [84,85].…”

Section: Sensitizing Tumors For Parp Inhibitorsmentioning

confidence: 99%

Parp Inhibitors: The Journey from Research Hypothesis to Clinical Approval

Naipal

Gent

2015

Per. Med.

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Cancer puts an increasing burden on our healthcare system and is a major cause of death. Therefore, novel approaches are required to improve cancer treatment. Cancer cells have several hallmarks that could be therapeutically targeted. Importantly, every tumor has a different combination of aberrations affecting the different hallmarks. This review focuses on targeting one of these hallmarks, the DNA damage response (DDR). DDR defects can not only cause cancer, but they can also be exploited therapeutically. This plays an important role even in 'classical' (DNA damaging) chemotherapy and radiotherapy, but more precise targeting of specific defects is expected to increase treatment efficacy and decrease normal tissue toxicity. Poly-(ADP-ribose) polymerase (PARP) inhibitors are the first clinical example of such synthetic lethality in tumors having specific DDR defects. They are currently under investigation as DDR-targeting anticancer drugs and they progress quickly in clinical trials.

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Salvage prostate HDR brachytherapy combined with interstitial hyperthermia for local recurrence after radiation therapy failure

Abstract: IHT in combination with salvage HDR brachytherapy is a well tolerated and effective treatment.

Cited by 30 publications

References 21 publications

Educational article Salvage brachytherapy in combination with interstitial hyperthermia for locally recurrent prostate carcinoma following external beam radiation therapy: a prospective phase II study

Educational article Salvage brachytherapy in combination with interstitial hyperthermia for locally recurrent prostate carcinoma following external beam radiation therapy: a prospective phase II study

Evaluation of tolerance and toxicity of high-dose-rate brachytherapy boost combined with interstitial hyperthermia for prostate cancer

Parp Inhibitors: The Journey from Research Hypothesis to Clinical Approval

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