PMID- 36831677
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230228
IS  - 2072-6694 (Print)
IS  - 2072-6694 (Electronic)
IS  - 2072-6694 (Linking)
VI  - 15
IP  - 4
DP  - 2023 Feb 20
TI  - A Contemporary Report of Low-Dose-Rate Brachytherapy for Prostate Cancer Using 
      MRI for Risk Stratification: Disease Outcomes and Patient-Reported Quality of 
      Life.
LID - 10.3390/cancers15041336 [doi]
LID - 1336
AB  - PURPOSE: We examined a prospective consecutive cohort of low dose rate (LDR) 
      brachytherapy for prostate cancer to evaluate the efficacy of monotherapy for 
      unfavorable-intermediate risk (UIR) disease, and explore factors associated with 
      toxicity and quality of life (QOL). METHODS: 149 men with prostate cancer, 
      including 114 staged with MRI, received Iodine-125 brachytherapy alone (144-145 
      Gy) or following external beam radiation therapy (110 Gy; EBRT). Patient-reported 
      QOL was assessed by the Expanded Prostate Index Composite (EPIC) survey, and 
      genitourinary (GU) and gastrointestinal (GI) toxicity were prospectively recorded 
      (CTC v4.0). Global QOL scores were assessed for decline greater than the minimum 
      clinically important difference (MCID). Univariate analysis (UVA) was performed, 
      with 30-day post-implant dosimetry covariates stratified into quartiles. Median 
      follow-up was 63 mo. RESULTS: Men with NCCN low (n = 42) or 
      favorable-intermediate risk (n = 37) disease were treated with brachytherapy 
      alone, while most with high-risk disease had combined EBRT (n = 17 of 18). Men 
      with UIR disease (n = 52) were selected for monotherapy (n = 42) based on 
      clinical factors and MRI findings. Freedom from biochemical failure-7 yr was 98%. 
      Of 37 men with MRI treated with monotherapy for UIR disease, all 36 men without 
      extraprostatic extension were controlled. Late Grade 2+/3+ toxicity occurred in 
      55/3% for GU and 8/2% for GI, respectively. Fifty men were sexually active at 
      baseline and had 2 yr sexual data; 37 (74%) remained active at 2 yr. Global 
      scores for urinary incontinence (UC), urinary irritation/obstruction (UIO), bowel 
      function, and sexual function (SF) showed decreases greater than the MCID (p < 
      0.05) in UC at 2 mo, UIO at 2 and 6 mo, and SF at 2-24 mo, and >5 yr. Analysis 
      did not reveal any significant associations with any examined rectal or urethral 
      dosimetry for late toxicity or QOL. CONCLUSION: Disease outcomes and 
      patient-reported QOL support LDR brachytherapy, including monotherapy for UIR 
      disease.
FAU - Patel, Mira
AU  - Patel M
AD  - Department of Radiation Oncology, University of Chicago Medicine, Chicago, IL 
      60637, USA.
FAU - Turchan, William Tyler
AU  - Turchan WT
AD  - Department of Radiation Oncology, University of Chicago Medicine, Chicago, IL 
      60637, USA.
FAU - Morris, Christopher G
AU  - Morris CG
AD  - Department of Radiation Oncology, University of Florida, Gainesville, FL 32610, 
      USA.
FAU - Augustine, Dana
AU  - Augustine D
AD  - Department of Radiation Oncology, University of Chicago Medicine, Chicago, IL 
      60637, USA.
FAU - Wu, Tianming
AU  - Wu T
AD  - Department of Radiation Oncology, University of Chicago Medicine, Chicago, IL 
      60637, USA.
FAU - Oto, Aytek
AU  - Oto A
AD  - Department of Radiology, University of Chicago Medicine, Chicago, IL 60637, USA.
FAU - Zagaja, Gregory P
AU  - Zagaja GP
AD  - Department of Urology, University of Chicago Medicine, Chicago, IL 60637, USA.
FAU - Liauw, Stanley L
AU  - Liauw SL
AD  - Department of Radiation Oncology, University of Chicago Medicine, Chicago, IL 
      60637, USA.
LA  - eng
PT  - Journal Article
DEP - 20230220
PL  - Switzerland
TA  - Cancers (Basel)
JT  - Cancers
JID - 101526829
PMC - PMC9953871
OTO - NOTNLM
OT  - MRI
OT  - brachytherapy
OT  - prostate cancer
OT  - quality of life
COIS- The authors declare that they have no conflict of interest.
EDAT- 2023/02/26 06:00
MHDA- 2023/02/26 06:01
PMCR- 2023/02/20
CRDT- 2023/02/25 01:42
PHST- 2023/01/11 00:00 [received]
PHST- 2023/02/08 00:00 [revised]
PHST- 2023/02/11 00:00 [accepted]
PHST- 2023/02/25 01:42 [entrez]
PHST- 2023/02/26 06:00 [pubmed]
PHST- 2023/02/26 06:01 [medline]
PHST- 2023/02/20 00:00 [pmc-release]
AID - cancers15041336 [pii]
AID - cancers-15-01336 [pii]
AID - 10.3390/cancers15041336 [doi]
PST - epublish
SO  - Cancers (Basel). 2023 Feb 20;15(4):1336. doi: 10.3390/cancers15041336.