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Influence of zonal dosimetry on prostate brachytherapy outcomes

PURPOSE: To examine the influence of zone-specific dosimetry on outcomes during permanent prostate implantation (PI), where the peripheral zone (PZ) and transitional zone (TZ) may receive varying radiation doses. MATERIAL AND METHODS: Four hundred and sixteen patients treated with I-125 PI (target d...

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Autores principales: Hong, Cheng William, Reddy, Chandana A., Wilkinson, D. Allan, Klein, Eric A., Ciezki, Jay P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4371063/
https://www.ncbi.nlm.nih.gov/pubmed/25829932
http://dx.doi.org/10.5114/jcb.2015.48875
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author Hong, Cheng William
Reddy, Chandana A.
Wilkinson, D. Allan
Klein, Eric A.
Ciezki, Jay P.
author_facet Hong, Cheng William
Reddy, Chandana A.
Wilkinson, D. Allan
Klein, Eric A.
Ciezki, Jay P.
author_sort Hong, Cheng William
collection PubMed
description PURPOSE: To examine the influence of zone-specific dosimetry on outcomes during permanent prostate implantation (PI), where the peripheral zone (PZ) and transitional zone (TZ) may receive varying radiation doses. MATERIAL AND METHODS: Four hundred and sixteen patients treated with I-125 PI (target dose: 144 Gy) between 1996 and 2003 were included in this Institutional Review Board (IRB) approved, retrospective analysis. Whole prostate (WP), TZ, and PZ were contoured, and zone-specific D(90) and V(100) were computed. Their influence on biochemical failure (BF) was evaluated using Cox proportional hazards analysis. RESULTS: The median age and initial prostate-specific antigen (PSA) was 68 years and 6.1 ng/ml, respectively, and the median follow-up time was 8.8 years. There were 329 subjects with Gleason score (GS) 6 disease (79.1%), and 82 subjects had GS 7 disease (19.7%). Androgen deprivation therapy (ADT) was used in 20.4% of patients. Median D(90) and V(100%) in the WP, PZ, and TZ were 141.2 Gy, 156.1 Gy, and 134.5 Gy; and 88.8%, 93.3%, and 84.2%, respectively. Ten-year rates for biochemical recurrence-free survival, distant metastasis-free survival, and prostate cancer-specific mortality were 82.4%, 92.4%, and 0.97% respectively. Only initial PSA, GS7+ disease, ADT, and PSA frequency were significant on multivariate analysis. Ten-year rates of grade 3 or higher GU and GI toxicity was 10.9% and 1.8%, respectively. TZ V(200) and TZ V(300) were significantly associated with late genitourinary toxicity. CONCLUSIONS: The TZ received significantly lower doses of radiation compared to the PZ. On multivariate analysis, no dosimetric parameter was associated with efficacy. Higher TZ doses may be associated with higher late GU toxicity without improving efficacy.
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spelling pubmed-43710632015-03-31 Influence of zonal dosimetry on prostate brachytherapy outcomes Hong, Cheng William Reddy, Chandana A. Wilkinson, D. Allan Klein, Eric A. Ciezki, Jay P. J Contemp Brachytherapy Original Paper PURPOSE: To examine the influence of zone-specific dosimetry on outcomes during permanent prostate implantation (PI), where the peripheral zone (PZ) and transitional zone (TZ) may receive varying radiation doses. MATERIAL AND METHODS: Four hundred and sixteen patients treated with I-125 PI (target dose: 144 Gy) between 1996 and 2003 were included in this Institutional Review Board (IRB) approved, retrospective analysis. Whole prostate (WP), TZ, and PZ were contoured, and zone-specific D(90) and V(100) were computed. Their influence on biochemical failure (BF) was evaluated using Cox proportional hazards analysis. RESULTS: The median age and initial prostate-specific antigen (PSA) was 68 years and 6.1 ng/ml, respectively, and the median follow-up time was 8.8 years. There were 329 subjects with Gleason score (GS) 6 disease (79.1%), and 82 subjects had GS 7 disease (19.7%). Androgen deprivation therapy (ADT) was used in 20.4% of patients. Median D(90) and V(100%) in the WP, PZ, and TZ were 141.2 Gy, 156.1 Gy, and 134.5 Gy; and 88.8%, 93.3%, and 84.2%, respectively. Ten-year rates for biochemical recurrence-free survival, distant metastasis-free survival, and prostate cancer-specific mortality were 82.4%, 92.4%, and 0.97% respectively. Only initial PSA, GS7+ disease, ADT, and PSA frequency were significant on multivariate analysis. Ten-year rates of grade 3 or higher GU and GI toxicity was 10.9% and 1.8%, respectively. TZ V(200) and TZ V(300) were significantly associated with late genitourinary toxicity. CONCLUSIONS: The TZ received significantly lower doses of radiation compared to the PZ. On multivariate analysis, no dosimetric parameter was associated with efficacy. Higher TZ doses may be associated with higher late GU toxicity without improving efficacy. Termedia Publishing House 2015-02-04 2015-02 /pmc/articles/PMC4371063/ /pubmed/25829932 http://dx.doi.org/10.5114/jcb.2015.48875 Text en Copyright © 2015 Termedia http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 3.0 Unported License, permitting all non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Paper
Hong, Cheng William
Reddy, Chandana A.
Wilkinson, D. Allan
Klein, Eric A.
Ciezki, Jay P.
Influence of zonal dosimetry on prostate brachytherapy outcomes
title Influence of zonal dosimetry on prostate brachytherapy outcomes
title_full Influence of zonal dosimetry on prostate brachytherapy outcomes
title_fullStr Influence of zonal dosimetry on prostate brachytherapy outcomes
title_full_unstemmed Influence of zonal dosimetry on prostate brachytherapy outcomes
title_short Influence of zonal dosimetry on prostate brachytherapy outcomes
title_sort influence of zonal dosimetry on prostate brachytherapy outcomes
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4371063/
https://www.ncbi.nlm.nih.gov/pubmed/25829932
http://dx.doi.org/10.5114/jcb.2015.48875
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