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High-dose-rate brac...
High-dose-rate brachytherapy as monotherapy for low- and intermediate-risk prostate cancer : long-term experience of Swedish single-center
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- Johansson, Bengt, 1958- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Oncology
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- Olsén, Johan Staby (författare)
- Department of Oncology, Central Hospital of Karlstad, Karlstad, Sweden
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- Karlsson, Leif (författare)
- Department of Medical Physics, Örebro University Hospital, Örebro, Sweden
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- Lundin, Erik, 1970- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Oncology
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- Lennernäs, Bo (författare)
- Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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(creator_code:org_t)
- 2021
- 2021
- Engelska.
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Ingår i: Journal of Contemporary Brachytherapy. - : Termedia Publishing. - 1689-832X .- 2081-2841. ; 13:3, s. 245-253
- Relaterad länk:
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https://doi.org/10.5...
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https://www.termedia...
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https://urn.kb.se/re...
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https://doi.org/10.5...
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Abstract
Ämnesord
Stäng
- Purpose: Until now, most long-term results for brachytherapy only has been published for low-dose-rate (LDR) seeds. Due to radiobiology reasons, high-dose-rate (HDR) mono-brachytherapy is of growing interest. The aim of the study was to report long-term biochemical control rate and toxicities with HDR monotherapy.Material and methods: This was a retrospective single-institution experience, including 229 men, clinically staged T1c-T2b, Gleason 3 + 3 (prostate specific antigen (PSA) <= 15), or Gleason 3 + 4 (PSA <= 10), consecutively treated between 2004 and 2012 with HDR brachytherapy alone, using three different fractionation schedules of 92-95 Gy (EQD(2), alpha/beta = 3). Group 4F (n = 19) had a single implant of 9.5 Gy in four fractions over 2 days. Group 3F (n = 107) had three separate implants of 11 Gy over 4 weeks. Group 2F (n = 103) had two implants of 14 Gy over 2 weeks. No adjuvant hormonal therapy was allowed.Results: For 4F, 3F, and 2F study groups, median follow-up was 10.2, 7.1, and 6.1 years, respectively, and biochemical failure rate was 10.5%, 4.7%, and 14.6%, respectively. Early and late side effects were followed with common terminology criteria version 2.0 and patient-reported questionnaires. There were a temporary acute urethral toxicity increase, 1-2 grades over baseline lower urinary tract symptoms (LUTS), which usually recovered. About 1/3 of the patients had a remaining one grade over baseline LUTS. Severe grade 3-4 toxicity were only found in 3.5% of patients. No rectal toxicity was observed. Erectile dysfunction (ED) was depending on age and erectile function before treatment. In patients without ED before the treatment, we found a complete ED in 21% of men at the last follow-up.Conclusions: In the present study, HDR mono-brachytherapy was found to be an effective treatment, with mild long-term side effects difficult to differentiate from aging effects. There were no significant differences in PSA regression, PSA failure rate, and toxicity between the different fraction schedules.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Nyckelord
- prostate cancer
- HDR
- brachytherapy
- monotherapy
- outcome
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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