Brachyterápiás boost besugárzás nagy kockázatú, lokalizált prosztatarák kezelésében

elsô hazai tapasztalatok.

Translated title of the contribution: Brachytherapy boost irradiation in the treatment of high risk, localised prostate cancer. Initial national experience in Hungary

Péter Agoston, Tibor Major, András Somogyi, Miklós Szûcs, Agnes Danczig, József Lövey, Csaba Polgár, János Fodor, György Németh, Miklós Kásler

Research output: Contribution to journalArticle

Abstract

PURPOSE: To describe the technique and early results of ultrasound (US)-guided interstitial prostate brachytherapy (BT) introduced at our institute. MATERIALS AND METHODS: Between December 2001 and July 2002, ten patients with clinically localised, high risk prostate cancer were treated with external beam irradiation and high dose rate (HDR) BT boost at the Radiotherapy Department of National Institute of Oncology, Budapest. Using CT based treatment planning, 46 Gy was delivered to the whole pelvis and then the prostate and vesicles were treated up to a total dose of 60 Gy by conformal external beams. BT boost was given in the first four weeks of external irradiation. Nine patients were under total androgen blockade. The interstitial BT was performed in spinal anaesthesia. Steel needles were implanted into the prostate using transrectal US guidance. The Ir-192 HDR isotope was loaded into the needles by remote control after-loading equipment. Treatment planning was based on transversal ultrasound images. The target volume was the whole prostate. The median number of inserted needles was 9 (range: 5-13). The prescribed dose to the surface of the prostate was 8 or 10 Gy, and the maximum reference dose of the urethra or rectum was less than 125% and 80% of the prescribed dose, respectively. PSA (prostate specific antigen) levels and acute side effects were monitored and documented regularly. RESULTS: The prescribed treatment was completed on all patients. The median follow-up time from the completion of the radiotherapy was 6 months (range: 2-11 months). Perioperative side effects (haematuria caused by puncture of the bladder) occurred in two cases. Acute grade 2 toxicity was observed in four patients: genitourinal inflammation in 4, and proctitis in 2 cases. No PSA relapse occurred so far. CONCLUSION: In our study we described our technique of interstitial BT boost as a part of prostate radiotherapy used for the first time in Hungary. The US based treatment planning resulted in adequate dose distribution in all cases. Incidence of perioperative and acute side effects were comparable to data known from the literature. Appropriate technical background and well organised team work are needed to ensure the good quality of the treatment.

Original languageHungarian
Pages (from-to)81-88
Number of pages8
JournalMagyar Onkologia
Volume48
Issue number1
Publication statusPublished - 2004

Fingerprint

Hungary
Brachytherapy
Prostate
Prostatic Neoplasms
Needles
Radiotherapy
Prostate-Specific Antigen
Therapeutics
Proctitis
Spinal Anesthesia
Steel
Hematuria
Urethra
Pelvis
Punctures
Rectum
Isotopes
Androgens
Urinary Bladder
Inflammation

ASJC Scopus subject areas

  • Cancer Research

Cite this

Brachyterápiás boost besugárzás nagy kockázatú, lokalizált prosztatarák kezelésében : elsô hazai tapasztalatok. / Agoston, Péter; Major, Tibor; Somogyi, András; Szûcs, Miklós; Danczig, Agnes; Lövey, József; Polgár, Csaba; Fodor, János; Németh, György; Kásler, Miklós.

In: Magyar Onkologia, Vol. 48, No. 1, 2004, p. 81-88.

Research output: Contribution to journalArticle

@article{79e8db1cfe95410da5116ca00cca04f2,
title = "Brachyter{\'a}pi{\'a}s boost besug{\'a}rz{\'a}s nagy kock{\'a}zat{\'u}, lokaliz{\'a}lt prosztatar{\'a}k kezel{\'e}s{\'e}ben: els{\^o} hazai tapasztalatok.",
abstract = "PURPOSE: To describe the technique and early results of ultrasound (US)-guided interstitial prostate brachytherapy (BT) introduced at our institute. MATERIALS AND METHODS: Between December 2001 and July 2002, ten patients with clinically localised, high risk prostate cancer were treated with external beam irradiation and high dose rate (HDR) BT boost at the Radiotherapy Department of National Institute of Oncology, Budapest. Using CT based treatment planning, 46 Gy was delivered to the whole pelvis and then the prostate and vesicles were treated up to a total dose of 60 Gy by conformal external beams. BT boost was given in the first four weeks of external irradiation. Nine patients were under total androgen blockade. The interstitial BT was performed in spinal anaesthesia. Steel needles were implanted into the prostate using transrectal US guidance. The Ir-192 HDR isotope was loaded into the needles by remote control after-loading equipment. Treatment planning was based on transversal ultrasound images. The target volume was the whole prostate. The median number of inserted needles was 9 (range: 5-13). The prescribed dose to the surface of the prostate was 8 or 10 Gy, and the maximum reference dose of the urethra or rectum was less than 125{\%} and 80{\%} of the prescribed dose, respectively. PSA (prostate specific antigen) levels and acute side effects were monitored and documented regularly. RESULTS: The prescribed treatment was completed on all patients. The median follow-up time from the completion of the radiotherapy was 6 months (range: 2-11 months). Perioperative side effects (haematuria caused by puncture of the bladder) occurred in two cases. Acute grade 2 toxicity was observed in four patients: genitourinal inflammation in 4, and proctitis in 2 cases. No PSA relapse occurred so far. CONCLUSION: In our study we described our technique of interstitial BT boost as a part of prostate radiotherapy used for the first time in Hungary. The US based treatment planning resulted in adequate dose distribution in all cases. Incidence of perioperative and acute side effects were comparable to data known from the literature. Appropriate technical background and well organised team work are needed to ensure the good quality of the treatment.",
author = "P{\'e}ter Agoston and Tibor Major and Andr{\'a}s Somogyi and Mikl{\'o}s Sz{\^u}cs and Agnes Danczig and J{\'o}zsef L{\"o}vey and Csaba Polg{\'a}r and J{\'a}nos Fodor and Gy{\"o}rgy N{\'e}meth and Mikl{\'o}s K{\'a}sler",
year = "2004",
language = "Hungarian",
volume = "48",
pages = "81--88",
journal = "Magyar Onkologia",
issn = "0025-0244",
publisher = "Akademiai Kiado",
number = "1",

}

TY - JOUR

T1 - Brachyterápiás boost besugárzás nagy kockázatú, lokalizált prosztatarák kezelésében

T2 - elsô hazai tapasztalatok.

AU - Agoston, Péter

AU - Major, Tibor

AU - Somogyi, András

AU - Szûcs, Miklós

AU - Danczig, Agnes

AU - Lövey, József

AU - Polgár, Csaba

AU - Fodor, János

AU - Németh, György

AU - Kásler, Miklós

PY - 2004

Y1 - 2004

N2 - PURPOSE: To describe the technique and early results of ultrasound (US)-guided interstitial prostate brachytherapy (BT) introduced at our institute. MATERIALS AND METHODS: Between December 2001 and July 2002, ten patients with clinically localised, high risk prostate cancer were treated with external beam irradiation and high dose rate (HDR) BT boost at the Radiotherapy Department of National Institute of Oncology, Budapest. Using CT based treatment planning, 46 Gy was delivered to the whole pelvis and then the prostate and vesicles were treated up to a total dose of 60 Gy by conformal external beams. BT boost was given in the first four weeks of external irradiation. Nine patients were under total androgen blockade. The interstitial BT was performed in spinal anaesthesia. Steel needles were implanted into the prostate using transrectal US guidance. The Ir-192 HDR isotope was loaded into the needles by remote control after-loading equipment. Treatment planning was based on transversal ultrasound images. The target volume was the whole prostate. The median number of inserted needles was 9 (range: 5-13). The prescribed dose to the surface of the prostate was 8 or 10 Gy, and the maximum reference dose of the urethra or rectum was less than 125% and 80% of the prescribed dose, respectively. PSA (prostate specific antigen) levels and acute side effects were monitored and documented regularly. RESULTS: The prescribed treatment was completed on all patients. The median follow-up time from the completion of the radiotherapy was 6 months (range: 2-11 months). Perioperative side effects (haematuria caused by puncture of the bladder) occurred in two cases. Acute grade 2 toxicity was observed in four patients: genitourinal inflammation in 4, and proctitis in 2 cases. No PSA relapse occurred so far. CONCLUSION: In our study we described our technique of interstitial BT boost as a part of prostate radiotherapy used for the first time in Hungary. The US based treatment planning resulted in adequate dose distribution in all cases. Incidence of perioperative and acute side effects were comparable to data known from the literature. Appropriate technical background and well organised team work are needed to ensure the good quality of the treatment.

AB - PURPOSE: To describe the technique and early results of ultrasound (US)-guided interstitial prostate brachytherapy (BT) introduced at our institute. MATERIALS AND METHODS: Between December 2001 and July 2002, ten patients with clinically localised, high risk prostate cancer were treated with external beam irradiation and high dose rate (HDR) BT boost at the Radiotherapy Department of National Institute of Oncology, Budapest. Using CT based treatment planning, 46 Gy was delivered to the whole pelvis and then the prostate and vesicles were treated up to a total dose of 60 Gy by conformal external beams. BT boost was given in the first four weeks of external irradiation. Nine patients were under total androgen blockade. The interstitial BT was performed in spinal anaesthesia. Steel needles were implanted into the prostate using transrectal US guidance. The Ir-192 HDR isotope was loaded into the needles by remote control after-loading equipment. Treatment planning was based on transversal ultrasound images. The target volume was the whole prostate. The median number of inserted needles was 9 (range: 5-13). The prescribed dose to the surface of the prostate was 8 or 10 Gy, and the maximum reference dose of the urethra or rectum was less than 125% and 80% of the prescribed dose, respectively. PSA (prostate specific antigen) levels and acute side effects were monitored and documented regularly. RESULTS: The prescribed treatment was completed on all patients. The median follow-up time from the completion of the radiotherapy was 6 months (range: 2-11 months). Perioperative side effects (haematuria caused by puncture of the bladder) occurred in two cases. Acute grade 2 toxicity was observed in four patients: genitourinal inflammation in 4, and proctitis in 2 cases. No PSA relapse occurred so far. CONCLUSION: In our study we described our technique of interstitial BT boost as a part of prostate radiotherapy used for the first time in Hungary. The US based treatment planning resulted in adequate dose distribution in all cases. Incidence of perioperative and acute side effects were comparable to data known from the literature. Appropriate technical background and well organised team work are needed to ensure the good quality of the treatment.

UR - http://www.scopus.com/inward/record.url?scp=3042570670&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=3042570670&partnerID=8YFLogxK

M3 - Article

VL - 48

SP - 81

EP - 88

JO - Magyar Onkologia

JF - Magyar Onkologia

SN - 0025-0244

IS - 1

ER -