scholarly journals Canadian Prostate Brachytherapy in 2012

2013 ◽  
Vol 7 (1-2) ◽  
pp. 51 ◽  
Author(s):  
Mira Keyes ◽  
Juanita Crook ◽  
W. James Morris ◽  
Gerard Morton ◽  
Tom Pickles ◽  
...  
Keyword(s):  
Dose Rate ◽  
Radiation Treatment ◽  
Specific Antigen ◽  
High Dose Rate ◽  
External Beam Radiation ◽  
High Dose ◽  
Prostate Brachytherapy ◽  
Eligibility Criteria ◽  
Beam Radiation ◽  
Risk Patients

Prostate brachytherapy can be used as a monotherapy for low- and intermediate-risk patients or in combination with external beam radiation therapy (EBRT) as a form of dose escalation for selected intermediate- and high-risk patients. Prostate brachytherapy with either permanent implants (low dose rate [LDR]) or temporary implants (high dose rate [HDR]) is emerging as the most effective radiation treatment for prostate cancer. Several large Canadian brachytherapy programs were established in the mid- to late-1990s. Prostate brachytherapy is offered in British Columbia, Alberta, Manitoba, Ontario, Quebec and New Brunswick. We anticipate the need for brachytherapy services in Canada will significantly increase in the near future. In this review, we summarize brachytherapy programs across Canada, contemporary eligibility criteria for the procedure, toxicity and prostate-specific antigen recurrence free survival (PRFS), as published from Canadian institutions for both LDR and HDR brachytherapy.

scholarly journals Focal Therapy, Differential Therapy, and Radiation Treatment for Prostate Cancer

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Anudh K. Jain ◽  
Ronald D. Ennis
Keyword(s):  
Prostate Cancer ◽  
Dose Rate ◽  
Radiation Treatment ◽  
Focal Therapy ◽  
High Dose Rate ◽  
External Beam Radiation ◽  
High Dose ◽  
Beam Radiation ◽  
Differential Therapy ◽  
Prostate Cancer Treatments

Focal and differential therapy represent an approach to improve the therapeutic ratio of prostate cancer treatments. This concept is a shift from treating the whole gland to intensely treating the portion of the gland that contains significant tumor. However, there are many challenges in the move towards focal approaches. Defining which patients are suitable candidates for focal therapy approaches is an area of significant controversy, and it is likely that additional data from imaging or detailed biopsy methods is needed in addition to traditional risk factors. A number of methods have been suggested, and imaging with multiparametric MRI and transperineal template mapping biopsy have shown promise. The approach of differential therapy where the entire prostate is treated to a lower intensity and the tumor areas to high intensity is also discussed in detail. Radiation therapy is a well suited modality for the delivery of differential therapy. Data in the literature using external beam radiation, high dose rate brachytherapy, and low-dose rate brachytherapy for differential therapy are reviewed. Preliminary results are encouraging, and larger studies and randomized controlled trials are needed to validate this approach.

Safety of high dose rate prostate brachytherapy in patients with high baseline international prostate symptom scores.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 25-25
Author(s):  
Tiffany Morgan ◽  
Peter John Rossi ◽  
Patrick Cutrell ◽  
Chao Zhang ◽  
Robert H. Press ◽  
...  
Keyword(s):  
Dose Rate ◽  
Foley Catheter ◽  
High Dose Rate ◽  
External Beam Radiation ◽  
High Dose ◽  
Prostate Brachytherapy ◽  
Beam Radiation ◽  
High Baseline ◽  
Gu Toxicity

25 Background: Though a high baseline international prostate symptom score (IPSS) is considered a relative contraindication for low dose rate (LDR) brachytherapy, use of high dose rate (HDR) technique has several theoretical advantages including increased ability to sculpt dose and spare normal tissue via post-implant dosimetry. We report our institutional QOL data for those undergoing HDR with an IPSS score ≥15 compared to those with an IPSS score <15. Methods: The charts of 95 patients with localized adenocarcinoma of the prostate treated with HDR as monotherapy or as a boost after external beam radiation (EBRT) at a single institution between 2012 and 2015 were reviewed. All patients completed the IPSS and Expanded Prostate Index for Prostate Cancer–Clinical Practice (EPIC-CP) quality of life assessments prior to treatment and at least one follow-up survey. Linear mixed models were performed to test for significant changes and differences in each outcome over time. Results: Median follow-up in the IPSS <15 group (n=79) was 23 months and 16 months in the IPSS ≥15 group (n=16). Median IPSS score was 6 (range 0-14) and 19 (range 15-30), respectively. A majority of patients in both groups were diagnosed with National Comprehensive Cancer Network (NCCN) intermediate risk disease. Median prostate volume was 45.4cc in the IPSS ≥15 group and 46.3cc in the IPSS <15 group (p=0.901). IPSS, incontinence, and urinary irritation/obstruction scores were significantly higher in the IPSS ≥15 group compared to the IPSS <15 group at baseline (all p≤0.05). By the >24 months time point, these scores had decreased below baseline and were not significantly different from those with a baseline IPSS score <15 (all p>0.1). 12.5% in the IPSS ≥15 group developed a new grade 2 GU toxicity requiring an alpha-blocker compared to 26.5% in the IPSS <15 group (p=0.34). No patients required emergency placement of a foley catheter within 30 days of treatment. Conclusions: Given the low rates of GU toxicity, including a low risk of urinary obstruction requiring catheterization after HDR brachytherapy for those with a baseline IPSS score ≥15, this technique appears appropriate even for those with high baseline urinary symptoms.

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