Single-fraction high-dose-rate brachytherapy using real-time transrectal ultrasound based planning in combination with external beam radiotherapy for prostate cancer: Dosimetrics and early clinical results - 21/09/16
, G. Delouya 2, D. Taussky 2, C. Ménard 2, D. Béliveau-Nadeau 2, Y. Hervieux 2, R. Larouche 2, M. Barkati 2Résumé |
Purpose |
To validate the feasibility of a single-fraction high-dose-rate brachytherapy (HDRBT) boost for prostate cancer using real-time transrectal ultrasound (TRUS) based planning.
Material and methods |
From August 2012 to September 2015, 126 patients underwent a single-fraction HDRBT boost of 15Gy using real-time TRUS based planning. External beam radiation therapy (EBRT) (37.5Gy/15fractions, 44Gy/22 fractions, or 45Gy/25 fractions) was performed before (31%) or after (69%) HDRBT boost. Genito-urinary (GU) and gastro-intestinal (GI) toxicity were assessed 4 and 12months after the end of combined treatment using the international prostate symptom score scale (IPSS) and the common terminology criteria for adverse events (CTCAE) v3.0.
Results |
All dose-planning objectives were achieved in 90% of patients. Prostate D90≥105% and≤115% was achieved in 99% of patients, prostate V150≤40% in 99%, prostate V200<11% in 96%, urethra D10<120% for 99%, urethra V125=0% in 100%, and rectal V75<1 cm3 in 93% of patients. Median IPSS score was 4 at baseline and did not change at 4 and 12months after combined treatment. No patients developed≥grade 2 GI toxicity. With a median follow-up of 10months, only two patients experienced biochemical failure. Among patients who didn’t receive ADT, cumulative percentage of patients with PSA≤1ng/mL at 4 and 18months was respectively 23 and 66%.
Conclusion |
Single-fraction HDRBT boost of 15Gy using real-time TRUS based planning achieves consistently high dosimetry quality.
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Vol 20 - N° 6-7
P. 744 - octobre 2016 Retour au numéro
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