ESTRO 2019: High-Dose-Rate Monotherapy for Localized Prostate Cancer
Posted: Tuesday, May 14, 2019
High-dose rate (HDR) brachytherapy delivered in a single dose seems to be both effective and safe in the treatment of localized prostate cancer. In addition, it was well tolerated for the first 2 years of treatment and had “good” early biochemical control, based on outcomes from a national UK database. Hannah Tharmalingam, MRCP, FRCR, of the Mount Vernon Cancer Centre, Northwood, and The Christie NHS Foundation Trust, Manchester, United Kingdom, and colleagues presented their findings at the 2019 European Society for Radiology and Oncology (ESTRO) 38 conference (Abstract OC-0633).
“This type of treatment offers an attractive alternative to surgery or other forms of radiotherapy, as it has a comparatively low risk of side effects,” said Dr. Tharmalingam in an ESTRO press release. “It is also a patient-friendly option because the treatment can be given quickly at a single hospital visit.”
The study focused on 369 patients with low-, intermediate-, and high-risk prostate cancer from 2013 to 2018. All patients were treated with HDR monotherapy to 19 Gy in a single treatment. After a median of 26 months, the 2-year biochemical progression-free survival was 96% for all patients. Low-, intermediate-, and high-risk patients had progression-free survival rates of 100%, 97%, and 95%, respectively. The site of relapse was radiologically identified in 21 of the 27 biochemical failures, and 14 of them had prostate recurrence.
Grade 2 genitourinary and gastrointestinal toxicities peaked 1 month after treatment, with 12% of patients experiencing genitourinary and 3% experiencing gastrointestinal effects. Additionally, 2 patients developed late grade 3 genitourinary adverse events; both were surgically managed urethral strictures. Two other patients developed late stage 3 gastrointestinal toxicity requiring colostomy. There were no grade 3 or 4 acute toxicities reported.
Disclosure: The study authors’ disclosure information may be found at cmoffice.estronet.eu.