Brachytherapy
-
Randomized Controlled Trial
Using a surgical prostate-specific antigen threshold of >0.2 ng/mL to define biochemical failure for intermediate- and high-risk prostate cancer patients treated with definitive radiation therapy in the ASCENDE-RT randomized control trial.
To compare biochemical failure using a prostate-specific antigen (PSA) threshold of >0.2 ng/mL to that using Phoenix threshold (nadir+2 ng/mL). ⋯ Replacing Phoenix with a surgical threshold greatly increased biochemical failure after DE-EBRT boost but had no effect after LDR-PB. As a result of this finding, PSA outcomes after surgery or brachytherapy can be directly compared by using the surgical definition of PSA failure. In this context, a brachytherapy boost appears to produce superior b-PFS compared to contemporary surgical series.
-
Randomized Controlled Trial
Is supplemental external beam radiation therapy necessary for patients with higher risk prostate cancer treated with 103Pd? Results of two prospective randomized trials.
To determine the necessity and/or dose of supplemental external beam radiotherapy (EBRT) in conjunction with palladium-103 ((103)Pd) brachytherapy for high-risk prostate cancer patients. ⋯ With high-quality brachytherapy dose distributions, supplemental EBRT did not influence BF or PCSM for patients with intermediate-risk disease. The number of patients with Gleason score 8-9 was too small to determine the role of supplemental EBRT in that cohort.
-
Randomized Controlled Trial Clinical Trial
The impact of radiation dose to the urethra on brachytherapy-related dysuria.
To determine the effect of urethral dose on dysuria after permanent prostate brachytherapy. ⋯ Dysuria is common after brachytherapy, but typically minimal in severity. Urethral doses did not predict for either dysuria severity or normalization. Although preimplant I-PSS was the strongest predictor of maximum dysuria and isotope the best predictor for dysuria normalization, robust predictors for brachytherapy-related dysuria were not identified.
-
Randomized Controlled Trial Clinical Trial
Factors predictive of rectal bleeding after 103Pd and supplemental beam radiation for prostate cancer.
To evaluate the contribution of various clinical and radiation treatment parameters to the likelihood of late rectal bleeding after brachytherapy plus supplemental beam radiation (EB). ⋯ Considering the potential severity of rectal morbidities and their relationship to implant dose, we urge our colleagues to routinely monitor the rectal implant doses of their own patients to make sure that such doses are kept within an accepted range.
-
Randomized Controlled Trial Clinical Trial
Rectal function following brachytherapy with or without supplemental external beam radiation: results of two prospective randomized trials.
To evaluate the effect of isotope and supplemental external beam radiation therapy (XRT) on brachytherapy-related rectal morbidity, using prospective, patient-administered quality of life (QOL) assessments. ⋯ The multifactorial R-FAS elucidated fine gradations in bowel function of a severity less than RTOG Grade 3 morbidity. Of multiple clinical, treatment, and dosimetric parameters evaluated, only the minimum dose received by 5% of the rectum (D5) correlated with rectal dysfunction via the R-FAS instrument, while none of the evaluated parameters predicted for bowel dysfunction using the RTOG survey. Following permanent prostate brachytherapy, the ability to discern subtle changes in rectal function is dependent on the sensitivity of the survey instrument.