دورية أكاديمية
Prostate high dose-rate brachytherapy as monotherapy for low and intermediate-risk prostate cancer: Efficacy results from a randomized phase II clinical trial of one fraction of 19 Gy or two fractions of 13.5 Gy: A 9-year update.
| العنوان: | Prostate high dose-rate brachytherapy as monotherapy for low and intermediate-risk prostate cancer: Efficacy results from a randomized phase II clinical trial of one fraction of 19 Gy or two fractions of 13.5 Gy: A 9-year update. |
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| المؤلفون: | Hudson JM; Sunnybrook Odette Cancer Centre, University of Toronto, Canada., Loblaw A; Sunnybrook Odette Cancer Centre, University of Toronto, Canada., McGuffin M; Sunnybrook Odette Cancer Centre, University of Toronto, Canada., Chung HT; Sunnybrook Odette Cancer Centre, University of Toronto, Canada., Tseng CL; Sunnybrook Odette Cancer Centre, University of Toronto, Canada., Helou J; Sunnybrook Odette Cancer Centre, University of Toronto, Canada., Cheung P; Sunnybrook Odette Cancer Centre, University of Toronto, Canada., Szumacher E; Sunnybrook Odette Cancer Centre, University of Toronto, Canada., Liu S; Sunnybrook Odette Cancer Centre, University of Toronto, Canada., Zhang L; Sunnybrook Odette Cancer Centre, University of Toronto, Canada., Deabreu A; Sunnybrook Odette Cancer Centre, University of Toronto, Canada., Mamedov A; Sunnybrook Odette Cancer Centre, University of Toronto, Canada., Morton G; Sunnybrook Odette Cancer Centre, University of Toronto, Canada. Electronic address: gerard.morton@sunnybrook.ca. |
| المصدر: | Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2024 Jun 13; Vol. 198, pp. 110381. Date of Electronic Publication: 2024 Jun 13. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Scientific Publishers Country of Publication: Ireland NLM ID: 8407192 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-0887 (Electronic) Linking ISSN: 01678140 NLM ISO Abbreviation: Radiother Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Limerick : Elsevier Scientific Publishers Original Publication: Amsterdam : Elsevier Science Publishers, c1983- |
| مستخلص: | Background and Purpose: High dose-rate (HDR) brachytherapy as a monotherapy is an accepted treatment for localized prostate cancer, but the optimal dose and fractionation schedule remain unknown. We report on the efficacy of a randomized Phase II trial comparing HDR monotherapy delivered as 27 Gy in 2 fractions vs. 19 Gy in 1 fraction with a median follow-up of 9 years. Materials and Methods: Enrolled patients had low or intermediate-risk disease, <60 cc prostate volume and no androgen deprivation use. Patients were randomized to 27 Gy in 2 fractions delivered one week apart vs a single fraction of 19 Gy. Results: 170 patients were randomized: median age 65 years, median follow-up 107 months and median baseline PSA 6.35 ng/ml. NCCN risk categories comprised low (19 %), favourable (51 %), and unfavourable intermediate risk (30 %). The median PSA at 8 years was 0.08 ng/ml in the 2-fraction arm vs. 0.89 ng/ml in the single-fraction arm. The cumulative incidence of local failure at 8 years was 11.2 % in the 2-fraction arm vs. 35.9 % in the single-fraction arm (p < 0.001). The incidence of distant failure at 8 years was 3.8 % in the 2-fraction arm and 2.5 % in the single-fraction arm (p = 0.6). Conclusions: HDR monotherapy delivered in two fractions of 13.5 Gy demonstrated a persistent cancer control rate at 8 years and was well-tolerated. Single-fraction monotherapy yielded poor oncologic control and is not recommended. These findings contribute to the ongoing discourse on optimal HDR monotherapy strategies for low and intermediate-risk prostate cancer. Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: [John M. Hudson – No conflicts of interest relevant to the work presented. Andrew Loblaw – No conflicts of interest relevant to the work presented. Merrylee McGuffin – No conflicts of interest relevant to the work presented. Hans T. Chung – No conflicts of interest relevant to the work presented. Chia-Lin Tseng – Advisor/consultant with Abbvie. Joelle Helou – No conflicts of interest relevant to the work presented. Patrick Cheung – No conflicts of interest relevant to the work presented. Ewa Szumacher – No conflicts of interest relevant to the work presented. Stanley Liu – No conflicts of interest relevant to the work presented. Liying Zhang – No conflicts of interest relevant to the work presented. Andrea Deabreu – No conflicts of interest relevant to the work presented. Alexandre Mamedov – No conflicts of interest relevant to the work presented. Gerard Morton reports that financial support was provided by Canadian Association of Radiation Oncology]. (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.) |
| تواريخ الأحداث: | Date Created: 20240615 Latest Revision: 20240623 |
| رمز التحديث: | 20240624 |
| DOI: | 10.1016/j.radonc.2024.110381 |
| PMID: | 38879130 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1879-0887 |
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| DOI: | 10.1016/j.radonc.2024.110381 |