W. Robert Lee is the recipient of a Radiological Society of North America Educational Scholar Award for 2004–2006.
Late toxicity and biochemical recurrence after external-beam radiotherapy combined with permanent-source prostate brachytherapy
Analysis of Radiation Therapy Oncology Group study 0019
Article first published online: 5 MAR 2007
Copyright © 2007 American Cancer Society
Volume 109, Issue 8, pages 1506–1512, 15 April 2007
How to Cite
Lee, W. R., Bae, K., Lawton, C., Gillin, M., Morton, G., Firat, S., Baikadi, M., Kuettel, M., Greven, K. and Sandler, H. (2007), Late toxicity and biochemical recurrence after external-beam radiotherapy combined with permanent-source prostate brachytherapy. Cancer, 109: 1506–1512. doi: 10.1002/cncr.22560
- Issue published online: 4 APR 2007
- Article first published online: 5 MAR 2007
- Manuscript Accepted: 18 DEC 2006
- Manuscript Revised: 12 DEC 2006
- Manuscript Received: 31 OCT 2006
- biochemical recurrence;
- external-beam radiotherapy;
- gastrointestinal toxicity;
- genitourinary toxicity;
- permanent-source brachytherapy
The combination of external-beam radiotherapy and brachytherapy is used commonly to treat men with prostate cancer. In this analysis, the authors examined the rate of biochemical recurrence (BR) and late grade ≥3 genitourinary (GU) and gastrointestinal (GI) toxicity after treatment with external-beam radiotherapy and brachytherapy in a multiinstitutional, cooperative group setting.
All eligible patients received external-beam radiotherapy (45 Gray [Gy] in 25 fractions) followed 2 to 6 weeks later by an interstitial implant using iodine-125 to deliver an additional 108 Gy. BR was defined in 2 ways: according to the American Society for Therapeutic Radiology and Oncology (ASTRO) Consensus Definition (ACD) and according to the Phoenix definition (PD) (prostate-specific antigen nadir +2 ng/mL). The Radiation Therapy Oncology Group(RTOG)/European Organization for Research and Treatment of Cancer late radiation morbidity scoring system was used to grade all toxicity.
One hundred thirty-eight patients were enrolled, and 130 were eligible for the current analysis. The median follow-up for surviving patients was 49 months (range, 20–60 months). The 48-month estimate of late grade ≥3 GU/GI toxicity was 15% (95% confidence interval [95% CI], 8–21%), and the 48-month estimate of BR was 19% (95% CI, 12–26%) and 14% (95% CI, 8–20%) according to the ACD and PD, respectively.
The morbidity observed in this multiinstitutional, cooperative group study was slightly higher than that reported in recent RTOG studies using brachytherapy alone or high-dose external-beam radiotherapy. The BR rate observed in this report was similar to that observed with high-dose external-beam radiotherapy alone in similar patients. Cancer 2007. © 2007 American Cancer Society.