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Patients report fewer moderate and serious side effects with IMRT than with brachytherapy
November 08, 2006In one of the first studies to compare side effects of IMRT and permanent prostate brachytherapy (I-125) for treatment of low-risk prostate cancer, researchers say patients had fewer moderate and serious side effects when treated with IMRT. The study results were presented today at the 48th Annual Meeting of the American Society for Therapeutic Radiology and Oncology in Philadelphia.
"Both treatments demonstrated excellent PSA outcomes (biochemical control) after treatment," said Thomas N. Eade, MBChB, a fellow in the department of radiation oncology at Fox Chase Cancer Center. "The patients who received IMRT tended to be older, but even with that factor, IMRT was better tolerated." PSA, or prostate specific antigen, is measured by a blood test and used to determine if prostate cancer is present.
The study included 374 patients with low-risk prostate cancers treated at Fox Chase with either IMRT (216 patients) or I-125 seed brachytherapy (158 patients). Patients who received neoadjuvant hormones were excluded from the study. The IMRT dose ranged from 74 to 78 Gy. The implant dose was 145 Gy. IMRT patients were an average of three years older (median age 67.6 years compared to 64.7 years).
Serious long-term side effects were significantly higher in the I-125 patients, including urethral stricture (narrowing) and catheterization. Catheterization within the first three months was required in three of the IMRT patients and 11 of the I-125 patients. Only one IMRT patient and seven of the implant patients required catheterization more than three months after completing treatment.
"There are limited studies looking at long-term outcomes in IMRT as it is a relatively new technology," said Eade. "However, Fox Chase has been a leader in this area and is one of the only institutions that can investigate this question.
"This study shows men treated with brachytherapy have an increased risk of long-term side effects with brachytherapy as compared to IMRT," Eade said. "Advances in technologies will continue to improve outcomes for both treatment modalities, but for now IMRT delivers excellent cancer control with fewer long-term problems.\\\
Fox Chase Cancer Center
Serious long-term side effects were significantly higher in the I-125 patients, including urethral stricture (narrowing) and catheterization. Catheterization within the first three months was required in three of the IMRT patients and 11 of the I-125 patients. Only one IMRT patient and seven of the implant patients required catheterization more than three months after completing treatment.
"There are limited studies looking at long-term outcomes in IMRT as it is a relatively new technology," said Eade. "However, Fox Chase has been a leader in this area and is one of the only institutions that can investigate this question.
"This study shows men treated with brachytherapy have an increased risk of long-term side effects with brachytherapy as compared to IMRT," Eade said. "Advances in technologies will continue to improve outcomes for both treatment modalities, but for now IMRT delivers excellent cancer control with fewer long-term problems.\\\
Fox Chase Cancer Center
Brachytherapy Current Events and Brachytherapy News RSSTask force develops new radiation guidelines for brachytherapy
Radiation dose delivered to the prostate and nearby organs in every brachytherapy procedure should be carefully analyzed using post-implant CT or MRI and uniformly documented in every patient.
Hormone therapy for prostate cancer patients with heart conditions linked to increased death risk
Men with coronary artery disease-induced congestive heart failure or heart attack who receive hormone therapy before or along with radiation therapy for treatment of prostate cancer have an associated increased risk of death.
Study shows seed implants a suitable prostate cancer treatment option for men of all ages
Men diagnosed with prostate cancer have a number of treatments to choose from, but it's a daunting task to figure out the right mix of therapies for an individual patient.
Prostate cancer patients disease free after 5 years likely to be disease free after 10 years
Prostate cancer patients who receive brachytherapy and remain free of disease for five years or greater are unlikely to have a recurrence at 10 years.
External beam partial breast irradiation most cost-effective treatment
External beam partial breast irradiation (EB-PBI) is the most cost-effective method for treating postmenopausal women with early-stage breast cancer based on utilities, recurrence risks and costs when compared to whole breast radiotherapy (WBRT) and brachytherapy partial breast irradiation (brachy-PBI).
Long-term study shows low oxygen levels in prostate tumors can predict recurrence
Fox Chase Cancer Center researchers have discovered that low-oxygen regions in prostate tumors can be used to predict a rise in prostate-specific antigen (PSA) levels, a marker of tumor recurrence in prostate cancer.
Radiation device in the breast reduces complications for early stage breast cancer patients
A new study shows that the SAVI™ applicator, a small, expandable device inserted inside the breast to deliver partial breast irradiation, carries a low infection risk, a potential complication of such devices.
Agent Orange exposure increases veterans' risk of aggressive recurrence of prostate cancer
Veterans exposed to Agent Orange are at increased risk of aggressive recurrence of prostate cancer, researchers report.
High dosage brachytherapy obtains excellent results in head and neck tumors
High-dosage perioperative brachytherapy (applied within the surgical process) obtains excellent results in the treatment of head and neck tumours, at the same time as reducing the period of radiation.
Early results favorable for 5-day radiation treatment of early stage prostate cancer
Preliminary results show that a shortened course of radiation therapy for prostate cancer called stereotactic body radiation therapy (SBRT) provides good PSA response for early-stage prostate cancer and has the same side effects as other treatments.
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