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Predicting toxicity caused by high-dose-rate brachytherapy single boost for prostate cancer
Johan Staby Olsén1, Dalia Estefan2, Antonios Valachis3
1Department of Oncology, General Hospital of Karlstad, Sweden.
Journal of Contemporary Brachytherapy
|March 2, 2022
Summary
Combination radiotherapy for localized prostate cancer (PC) is well-tolerated, with generally mild and temporary toxicities. Severe side effects were infrequent, offering reassurance for this curative treatment approach.
Area of Science:
- Oncology
- Radiation Oncology
- Urology
Background:
- Combination radiotherapy using external beam radiotherapy (EBRT) and high-dose-rate brachytherapy (HDR-BT) improves outcomes for localized prostate cancer (PC) compared to EBRT alone.
- Evaluating treatment-related toxicities is crucial for patient management and treatment planning.
Purpose of the Study:
- To assess the incidence of urinary, rectal, and erectile toxicities following combination EBRT and HDR-BT for localized PC.
- To identify predictors of acute and late toxicities associated with this combined treatment modality.
Main Methods:
- A cohort of 359 patients with localized PC treated between 2008-2018 with EBRT (42 Gy/14 fractions) and HDR-BT (14.5 Gy/1 fraction) were analyzed.
- Data on patient symptoms and tumor/treatment parameters were collected and analyzed using bivariate and multivariable statistical methods.
Main Results:
- Grade ≥2 urinary toxicity occurred in 47% of patients, with 15 cases of grade 3. Grade 2 rectal toxicity was observed in 6% of patients.
- Erectile dysfunction was common in patients without pre-existing issues, with limited recovery. Age and irradiated volume showed correlations with urinary and rectal toxicities in bivariate analysis.
- No statistically significant multivariable models were identified to predict the risk of urinary or rectal toxicities.
Conclusions:
- The combination of EBRT and HDR-BT for localized PC demonstrated generally mild to moderate and temporary toxicities.
- The incidence of severe toxicity was low, indicating that this combined treatment is a well-tolerated and effective curative option for localized prostate cancer.
