Abstract Brachytherapy has played an important role in localized prostate cancer. High-dose-rate brachytherapy has evolved over the decades, as either monotherapy or in combination with external beam, it offers many advantages over other treatment alternatives. Precise control over dose delivery allows for focal dose escalation while sculpting dose around organs at risk to maintain excellent tolerance. The high dose per fraction exploits the low α/β ratio of prostate cancer and triggers transcriptional changes in the tumor genome, thereby enhancing radiation sensitivity. In this article, the development, patient selection, application of techniques, clinical efficacy and adverse events for high-dose-rate brachytherapy were summarized.
Fund:2021 Cangzhou Science and Technology Project Self-financing Project (213106092)
Corresponding Authors:
Sun Yunchuan, Email:sunyunchuan@163.com
Cite this article:
Guo Wei,Sun Yunchuan. Research progress on high-dose-rate brachytherapy of localized prostate cancer[J]. Chinese Journal of Radiation Oncology, 2022, 31(5): 478-482.
Guo Wei,Sun Yunchuan. Research progress on high-dose-rate brachytherapy of localized prostate cancer[J]. Chinese Journal of Radiation Oncology, 2022, 31(5): 478-482.
[1] Dearnaley DP, Jovic G, Syndikus I, et al. Escalated-dose versus control-dose conformal radiotherapy for prostate cancer:long-term results from the MRC RT01 randomised controlled trial[J]. Lancet Oncol,2014,15(4):464-473. DOI:10.1016/S1470-2045(14)70040-3. [2] Blasko JC, Grimm PD, Ragde H. Brachytherapy and organ preservation in the management of carcinoma of the prostate[J]. Semin Radiat Oncol, 1993, 3(4):240-249. DOI:10.1053/SRAO00300240. [3] Mate TP, Gottesman JE, Hatton J, et al. High dose-rate afterloading 192Iridium prostate brachytherapy:feasibility report[J]. Int J Radiat Oncol Biol Phys, 1998, 41(3):525-533. DOI:10.1016/s0360-3016(98)00097-2. [4] Martinez AA, Gonzalez J, Ye H, et al. Dose escalation improves cancer-related events at 10 years for intermediate-and high-risk prostate cancer patients treated with hypofractionated high-dose-rate boost and external beam radiotherapy[J]. Int J Radiat Oncol Biol Phys, 2011, 79(2):363-370. DOI:10.1016/j.ijrobp.2009.10.035. [5] Miralbell R, Roberts SA, Zubizarreta E, et al. Dose-fractionation sensitivity of prostate cancer deduced from radiotherapy outcomes of 5,969 patients in seven international institutional datasets:α/β= 1.4(0.9-2.2)Gy[J]. Int J Radiat Oncol Biol Phys, 2012, 82(1):e17-24. DOI:10.1016/j.ijrobp.2010.10.075. [6] Arrayeh E, Westphalen AC, Kurhanewicz J, et al. Does local recurrence of prostate cancer after radiation therapy occur at the site of primary tumor? Results of a longitudinal MRI and MRSI study[J]. Int J Radiat Oncol Biol Phys, 2012, 82(5):e787-793. DOI:10.1016/j.ijrobp.2011.11.030. [7] Martinez A, Gonzalez J, Stromberg J, et al. Conformal prostate brachytherapy:Initial experience of a phase Ⅰ/Ⅱ dose-escalating trial[J]. Int J Radiat Oncol Biol Phys, 1995, 33(5):1019-1027. DOI:10.1016/0360-3016(95)00254-5. [8] Kovács G, Pötter R, Loch T, et al. GEC/ESTRO-EAU recommendations on temporary brachytherapy using stepping sources for localised prostate cancer[J]. Radiother Oncol, 2005,74(2):137-148. DOI:10.1016/j.radonc.2004.09.004. [9] Hoskin PJ, Colombo A, Henry A, et al. GEC/ESTRO recommendations on high dose rate afterloading brachytherapy for localised prostate cancer:an update[J]. Radiother Oncol, 2013, 107(3):325-332. DOI:10.1016/j.radonc.2013.05.002. [10] Chin J, Rumble RB, Kollmeier M, et al. Brachytherapy for patients with prostate cancer:American society of clinical oncology/cancer care ontario joint guideline update[J]. J Clin Oncol, 2017, 35(15):1737-1743. DOI:10.1200/JCO.2016.72.0466. [11] Kaprealian T, Weinberg V, Speight JL, et al. High-dose-rate brachytherapy boost for prostate cancer:comparison of two different fractionation schemes[J]. Int J Radiat Oncol Biol Phys, 2012, 82(1):222-227. DOI:10.1016/j.ijrobp.2010.09.021. [12] Olarte A, Cambeiro M, Moreno-Jiménez M, et al. Dose escalation with external beam radiation therapy and high-dose-rate brachytherapy combined with long-term androgen deprivation therapy in high and very high risk prostate cancer:comparison of two consecutive high-dose-rate schemes[J]. Brachytherapy, 2016, 15(2):127-135. DOI:10.1016/j.brachy.2015.12.008. [13] Helou J, D'Alimonte L, Loblaw A, et al. High dose-rate brachytherapy boost for intermediate risk prostate cancer:long-term outcomes of two different treatment schedules and early biochemical predictors of success[J]. Radiother Oncol, 2015, 115(1):84-89. DOI:10.1016/j.radonc.2015.02.023. [14] Yamada Y, Rogers L, Demanes DJ, et al. American brachytherapy society consensus guidelines for high-dose-rate prostate brachytherapy[J]. Brachytherapy, 2012, 11(1):20-32. DOI:10.1016/j.brachy.2011.09.008. [15] Morton GC. High-dose-rate brachytherapy boost for prostate cancer:rationale and technique[J]. J Contemp Brachytherapy, 2014, 6(3):323-330. DOI:10.5114/jcb.2014.45759. [16] Galalae RM, Zakikhany NH, Geiger F, et al. The 15-year outcomes of high-dose-rate brachytherapy for radical dose escalation in patients with prostate cancer-a benchmark for high-tech external beam radiotherapy alone?[J]. Brachytherapy, 2014, 13(2):117-122. DOI:10.1016/j.brachy.2013.11.002. [17] Shahid N, Loblaw A, Chung HT, et al. Long-term toxicity and health-related quality of life after single-fraction high dose rate brachytherapy boost and hypofractionated external beam radiotherapy for intermediate-risk prostate cancer[J]. Clin Oncol (R Coll Radiol), 2017, 29(7):412-420. DOI:10.1016/j.clon.2017.01.042. [18] Pellizzon AC, Salvajoli J, Novaes P, et al. Updated results of high-dose rate brachytherapy and external beam radiotherapy for locally and locally advanced prostate cancer using the RTOG-ASTRO Phoenix definition[J]. Int Braz J Urol, 2008, 34(3):293-301. DOI:10.1590/s1677-55382008000300006. [19] Vigneault E, Mbodji K, Magnan S, et al. High-dose-rate brachytherapy boost for prostate cancer treatment:different combinations of hypofractionated regimens and clinical outcomes[J]. Radiother Oncol, 2017, 124(1):49-55. DOI:10.1016/j.radonc.2017.06.012. [20] Yaxley JW, Lah K, Yaxley JP, et al. Long-term outcomes of high-dose-rate brachytherapy for intermediate-and high-risk prostate cancer with a median follow-up of 10 years[J]. BJU Int, 2017, 120(1):56-60. DOI:10.1111/bju.13659. [21] Kishan AU, Shaikh T, Wang PC, et al. Clinical outcomes for patients with gleason score 9-10 prostate adenocarcinoma treated with radiotherapy or radical prostatectomy:A multi-institutional comparative analysis[J]. Eur Urol, 2017, 71(5):766-773. DOI:10.1016/j.eururo.2016.06.046. [22] Hoskin PJ, Rojas AM, Bownes PJ, et al. Randomised trial of external beam radiotherapy alone or combined with high-dose-rate brachytherapy boost for localised prostate cancer[J]. Radiother Oncol, 2012, 103(2):217-222. DOI:10.1016/j.radonc.2012.01.007. [23] Hindson BR, Millar JL, Matheson B. Urethral strictures following high-dose-rate brachytherapy for prostate cancer:analysis of risk factors[J]. Brachytherapy, 2013, 12(1):50-55. DOI:10.1016/j.brachy.2012.03.004. [24] Hauswald H, Kamrava MR, Fallon JM, et al. High-dose-rate monotherapy for localized prostate cancer:10-year results[J]. Int J Radiat Oncol Biol Phys, 2016, 94(4):667-674. DOI:10.1016/j.ijrobp.2015.07.2290. [25] Strouthos I, Tselis N, Chatzikonstantinou G, et al. High dose rate brachytherapy as monotherapy for localised prostate cancer[J]. Radiother Oncol, 2018, 126(2):270-277. DOI:10.1016/j.radonc.2017.09.038. [26] Jawad MS, Dilworth JT, Gustafson GS, et al. Outcomes associated with 3 treatment schedules of high-dose-rate brachytherapy monotherapy for favorable-risk prostate cancer[J]. Int J Radiat Oncol Biol Phys, 2016, 94(4):657-666. DOI:10.1016/j.ijrobp.2015.10.011. [27] Morton G, Chung HT, McGuffin M, et al. Prostate high dose-rate brachytherapy as monotherapy for low and intermediate risk prostate cancer:early toxicity and quality-of life results from a randomized phase Ⅱ clinical trial of one fraction of 19Gy or two fractions of 13.5Gy[J]. Radiother Oncol, 2017, 122(1):87-92. DOI:10.1016/j.radonc.2016.10.019. [28] Hoskin P, Rojas A, Ostler P, et al. Single-dose high-dose-rate brachytherapy compared to two and three fractions for locally advanced prostate cancer[J]. Radiother Oncol, 2017, 124(1):56-60. DOI:10.1016/j.radonc.2017.06.014. [29] Prada PJ, Cardenal J, Blanco AG, et al. High-dose-rate interstitial brachytherapy as monotherapy in one fraction for the treatment of favorable stage prostate cancer:toxicity and long-term biochemical results[J]. Radiother Oncol, 2016, 119(3):411-416. DOI:10.1016/j.radonc.2016.04.006. [30] Mendez LC, Morton GC. High dose-rate brachytherapy in the treatment of prostate cancer[J]. Transl Androl Urol, 2018, 7(3):357-370. DOI:10.21037/tau.2017.12.08. [31] Siddiqui ZA, Gustafson GS, Ye H, et al. Five-year outcomes of a single-institution prospective trial of 19-gy single-fraction high-dose-rate brachytherapy for low-and intermediate-risk prostate cancer[J]. Int J Radiat Oncol Biol Phys, 2019, 104(5):1038-1044. DOI:10.1016/j.ijrobp.2019.02.010. [32] Martinez AA, Demanes J, Vargas C, et al. High-dose-rate prostate brachytherapy:an excellent accelerated-hypofractionated treatment for favorable prostate cancer[J]. Am J Clin Oncol, 2010, 33(5):481-488. DOI:10.1097/COC.0b013e3181b9cd2f. [33] Jalloh M, Leapman MS, Cowan JE, et al. Patterns of local failure following radiation therapy for prostate cancer[J]. J Urol, 2015, 194(4):977-982. DOI:10.1016/j.juro.2015.04.111. [34] Crook JM, Zhang P, Pisansky TM, et al. A prospective phase 2 trial of transperineal ultrasound-guided brachytherapy for locally recurrent prostate cancer after external beam radiation therapy (NRG oncology/RTOG-0526)[J]. Int J Radiat Oncol Biol Phys, 2019, 103(2):335-343. DOI:10.1016/j.ijrobp.2018.09.039. [35] Kollmeier MA, McBride S, Taggar A, et al. Salvage brachytherapy for recurrent prostate cancer after definitive radiation therapy:A comparison of low-dose-rate and high-dose-rate brachytherapy and the importance of prostate-specific antigen doubling time[J]. Brachytherapy, 2017, 16(6):1091-1098. DOI:10.1016/j.brachy.2017.07.013. [36] Chen CP, Weinberg V, Shinohara K, et al. Salvage HDR brachytherapy for recurrent prostate cancer after previous definitive radiation therapy:5-year outcomes[J]. Int J Radiat Oncol Biol Phys, 2013, 86(2):324-329. DOI:10.1016/j.ijrobp.2013.01.027. [37] Yamada Y, Kollmeier MA, Pei X, et al. A phase Ⅱ study of salvage high-dose-rate brachytherapy for the treatment of locally recurrent prostate cancer after definitive external beam radiotherapy[J]. Brachytherapy, 2014, 13(2):111-116. DOI:10.1016/j.brachy.2013.11.005. [38] Wojcieszek P, Szlag M,Gowacki G, et al. Salvage high-dose-rate brachytherapy for locally recurrent prostate cancer after primary radiotherapy failure[J]. Radiother Oncol, 2016, 119(3):405-410. DOI:10.1016/j.radonc.2016.04.032.
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