Beta
272627

The Role of External Beam Radiotherapy With or Without Low Dose Rate Brachytherapy in Treatment of Intermediate Risk Cancer Prostate

Article

Last updated: 01 Jan 2025

Subjects

-

Tags

-

Abstract

Abstract Background: Patients with intermediate risk cancer prostate represent the largest risk group with remarkable clinical and biologic heterogeneity and are further subdivided into favorable intermediate risk (FIR) and unfavorable intermediate risk (UIR) subgroups with higher rates of deaths, biochemical and metastatic recurrences. Aim of Study: To investigate the difference between external beam radiation therapy (EBRT) and EBRT plus low-dose-rate brachytherapy (combo-RT) on tumor control and toxicity profile in patients with intermediate risk cancer prostate. Patients and Methods: A cohort of 579 patients withinter-mediate-risk cancer prostate were treated between 1995 and 2012 by either EBRT (n: 388) or combo-RT (n: 191). The aim of the study was to assess biochemical recurrence free survival (bRFS), distant metastasis free survival (DMFS), and cumu-lative incidence of genitourinary (GU) and gastrointestinal toxicity in the favorable and unfavorable subgroups. Results: At a median follow-up period at 7.5 yr, an im-provement in the 10 yr bRFS was evident in the patients treated with Combo-RT compared to those treated with EBRT alone (91.7% vs. 75.4%, p 5 0.014). Multivariate analysis showed that combo-RT was associated with improved bRFS with improvement of hazard ratio (HR, 0.48; 95% confidence interval: 0.25, 0.92; p 0.03). Such an improvement was statistically significant in unfavorable intermediate risk patients (p 5 0.02), but not in the favorable risk ones (p 5 0.37). For DMFS, no difference was found. An increase in the 6-year cumulative incidence rate of Grade 3 genitourinary toxicity was associatedwith Combo RT (HR, 3.48; 95% confidence interval: 1.1, 11.1; p 0.026). Conclusions: Treatment of intermediate-risk prostate cancer with combo-RT improved bRFS but not DMFS at the expense of increased Grade 3 genito urinary toxicity. Improve-ment in bRFS was found in unfavorable intermediate-risk patientsbut not in the favorable risk patients.

DOI

10.21608/mjcu.2022.272627

Keywords

Intermediate risk cancer prostate, Brachytherapy, Escalated dose external beam radiotherapy

Authors

First Name

ALI MOHAMED ALI, M.D.;

Last Name

AHMED E. ABUGHARIB, M.D.

MiddleName

-

Affiliation

-

Email

-

City

-

Orcid

-

First Name

AHMED

Last Name

M. AMEEN AHMED, M.D.*

MiddleName

-

Affiliation

The Department of Clinical Oncology*, Sohag University and Department of Radiation Oncology*,**, University of Michigan, Ann Arbor, MI

Email

-

City

-

Orcid

-

Volume

90

Article Issue

9

Related Issue

37084

Issue Date

2022-09-01

Receive Date

2022-12-05

Publish Date

2022-09-01

Page Start

1,757

Page End

1,764

Print ISSN

0045-3803

Online ISSN

2536-9806

Link

https://mjcu.journals.ekb.eg/article_272627.html

Detail API

https://mjcu.journals.ekb.eg/service?article_code=272627

Order

272,627

Type

Original Article

Type Code

263

Publication Type

Journal

Publication Title

The Medical Journal of Cairo University

Publication Link

https://mjcu.journals.ekb.eg/

MainTitle

The Role of External Beam Radiotherapy With or Without Low Dose Rate Brachytherapy in Treatment of Intermediate Risk Cancer Prostate

Details

Type

Article

Created At

22 Jan 2023