Purpose

The purpose of this study was to investigate the clinical outcomes, urinary function, quality of life (QOL), and toxicities in high- or very high-risk prostate cancer patients undergoing single-fraction high-dose-rate brachytherapy (HDR-BT) with external beam radiotherapy (EBRT) and analyze the relationship between dosimetric parameters and toxicities.

Materials and methods

Between April 2014 and April 2019, 124 patients underwent 13-Gy HDR-BT followed by EBRT (46 Gy/23 fractions). Urinary function and QOL were evaluated using IPSS and 7-grade QOL Scale, respectively. Biochemical progression-free survival (bPFS) was calculated.

Results

Median follow-up period was 35.8 months; all patients received neoadjuvant hormonal therapy and very high-risk patients received adjuvant hormonal therapy. Only one patient developed a grade 3 toxicity (hematuria). Multivariate analysis showed the dose covering 30% of the urethral volume, bladder volume receiving 75% of the dose, and dose covering 2 cc of rectum were independent predictors of acute G2 urinary frequency, acute G2 urinary retention, and late G2 rectal hemorrhage. IPSS and QOL scores significantly increased following HDR-BT and returned to baseline within 6 months. The 2-year bPFS was 99.2%.

Conclusion

The single-fraction HDR-BT with EBRT is a safe treatment for quicker recovery of urinary symptoms and QOL. The dose of at-risk organs correlated with toxicities.

Secondary abstract

Single-fraction high-dose-rate brachytherapy (HDR-BT) combined with external beam radiotherapy (EBRT) for prostate cancer is a safe treatment allowing for quicker recovery of urinary symptoms and QOL. The dose of at-risk organs correlated with toxicities.

中文翻译：

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单次高剂量率近距离放射疗法与外照射疗法联合治疗高/非常高风险前列腺癌的毒性和临床结果：毒性剂量学分析。

目的

这项研究的目的是调查接受单次高剂量率近距离放射治疗（HDR-BT）的高危或高危前列腺癌患者的临床结局，尿功能，生活质量（QOL）和毒性外放射线疗法（EBRT）进行分析，并分析剂量参数与毒性之间的关系。

材料和方法

在2014年4月至2019年4月，共有124例患者接受了13-Gy HDR-BT，随后接受了EBRT（46 Gy / 23分次）。分别使用IPSS和7级QOL量表评估尿功能和QOL。计算无生化无进展生存期（bPFS）。

结果

中位随访时间为35.8个月；所有患者均接受新辅助激素治疗，极高危患者接受辅助激素治疗。只有一名患者出现3级毒性（血尿）。多变量分析显示，尿量占尿道容积的30％，膀胱容积占剂量的75％和直肠癌的剂量2 cc是急性G2尿频，急性G2尿retention留和晚期G2直肠出血的独立预测因子。HDR-BT后IPSS和QOL评分显着提高，并在6个月内恢复到基线。2年bPFS为99.2％。

结论

具有EBRT的单组分HDR-BT是一种安全的治疗方法，可以更快地恢复泌尿症状和QOL。高危器官的剂量与毒性有关。

次要摘要

单次高剂量率近距离放射疗法（HDR-BT）结合外部放射线放射疗法（EBRT）用于前列腺癌是一种安全的治疗方法，可以更快地恢复泌尿症状和QOL。高危器官的剂量与毒性有关。