Toxicity Similar for 6- and 2- Fraction HDR Brachytherapy in PCa

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There was a correlation for worsened SHIM score with increasing age, diabetes mellitus, and androgen-deprivation therapy.
There was a correlation for worsened SHIM score with increasing age, diabetes mellitus, and androgen-deprivation therapy.

(HealthDay News) — For men with prostate cancer there is no difference in acute genitourinary or sexual dysfunction between 6- and 2-fraction high-dose-rate (HDR) brachytherapy monotherapy, according to a study published online in the Journal of Medical Imaging and Radiation Oncology.

Omar Ragab, MD, from the University of Southern California in Los Angeles, and colleagues conducted a retrospective study involving 116 men with prostate cancer treated with HDR monotherapy from 2010 to 2015. Eighty-one and 35 men had 7.25 Gy × 6-fractions and 13.5 Gy × 2-fractions, respectively. Patients underwent 2 computed tomography-planned implants spaced 1 to 2 weeks apart. Pre-treatment and at 3, 6, and 12 months post-implantation, patient baseline characteristics, International Prostate Symptom Scores (IPSS), and Sexual Health Inventory for Men (SHIM) scores were collected.

The researchers found that there was no difference between the 6- and 2-fraction groups in baseline and post-implantation IPSS scores. Men treated with 6-fractions had a steeper decline in SHIM scores at 1 to 6 months, but it resolved at 7 to 12 months. Worse short-term acute urinary toxicity was seen with pre-treatment alpha-blocker use. There was a correlation for worsened SHIM score with increasing age, diabetes mellitus, and androgen-deprivation therapy. Prostate V150 dose and bladder wall dose correlated with increased IPSS score in a dosimetric analysis of outcomes.

"Future research should continue to standardize and validate dose constraints for prostate HDR monotherapy patients," the authors write.

Reference

  1. Ragab O, Banerjee R, Park SJ, et al. Comparison of patient-reported acute urinary and sexual toxicity scores in a 6- versus 2-fraction course of high-dose-rate prostate brachytherapy monotherapy. J Med Imaging Radiat Oncol. 2017 Aug 29. doi: 10.1111/1754-9485.12648
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