Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
-
To report on the incidence of benign prostate-specific antigen bounce following permanent I(125) prostate brachytherapy, to describe the associations in our population and review the relationship of bounce to subsequent biochemical failure. ⋯ PSA bounce is a common finding in our population and is associated with a lower rate of subsequent biochemical failure. The noted differences in PSA velocity will require verification in a future analysis to reduce the influence of median follow-up on this finding. Patients should be advised of the potential of bounce in PSA follow-up after permanent I(125) prostate brachytherapy and physicians involved in follow-up of prostate brachytherapy patients should be aware of this phenomenon, allowing them to commit to appropriate PSA surveillance, avoiding the premature and inappropriate initiation of salvage therapy during PSA bounce.
-
The aim of the study was to analyze health-related quality of life changes after postoperative radiotherapy (RT) for prostate cancer. ⋯ In contrast to bowel symptoms, acute urinary problems recover very soon after the end of postoperative RT. After >1 year, only minor HRQOL changes occurred in comparison to baseline scores.
-
The two main modalities to deliver high dose to the prostate and prevent high doses to neighboring organs are intensity modulated radiotherapy (IMRT) or external beam radiotherapy combined with brachytherapy. Because of the different biological effectiveness the physical dose distributions were converted to 3-dimensional linear quadratic dose at 2 Gy per fraction (EQD(2)). From the latter, cumulative EQD(2)-volume histograms were determined for comparison of the modalities. ⋯ Because of the high doses within an implant, the dose in 50% of the prostate volume is much higher with the brachytherapy modalities than IMRT-only which may have clinical consequences. With brachytherapy the doses to the OAR are lower or similar to IMRT-only. Dose escalation for prostate tumors is more easily achieved with brachytherapy than with IMRT alone. Therefore, brachytherapy might be the preferred modality to achieve further dose escalation.
-
Lower urinary tract symptoms are frequently observed after I-125 seed implantation of the prostate. More knowledge about causes and predictors is necessary to be able to develop less toxic implantation techniques. The aim of this study was to identify implantation related factors that contribute to post-implant urinary morbidity. ⋯ Bladder hotspot dose appears to be an important dosimetric predictor for urinary morbidity both at 3 months and at 6 months after implantation. Other predictors are prostate volume, or equivalently, the number of implanted seeds.