Pulmonary Metastases After Low-Dose-Rate Brachytherapy for Localized Prostate Cancer.
10.4111/kju.2014.55.5.309
- Author:
Masahito KIDO
1
;
Hidetoshi KURUMA
;
Hiroshi SASAKI
;
Kenta MIKI
;
Manabu AOKI
;
Takahiro KIMURA
;
Hiroyuki TAKAHASH
;
Chihiro KANEHIRA
;
Shin EGAWA
Author Information
1. Department of Urology, Jikei University School of Medicine, Tokyo, Japan. hkuruma@gmail.com
- Publication Type:Original Article
- Keywords:
Brachytherapy;
Neoplasm metastasis;
Prostate neoplasms
- MeSH:
Brachytherapy*;
Follow-Up Studies;
Humans;
Neoplasm Metastasis*;
Passive Cutaneous Anaphylaxis;
Prostatic Neoplasms*;
Radiotherapy;
Recurrence
- From:Korean Journal of Urology
2014;55(5):309-314
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To analyze unusual events and focus discussion on pulmonary metastasis in particular after low-dose-rate brachytherapy (LDR-BT) for prostate cancer (PCa). MATERIALS AND METHODS: A total of 616 consecutive patients who had undergone LDR-BT for clinically localized PCa at Jikei University Hospital between October 2003 and April 2010 were enrolled in this study. Follow-up information was summarized, and patterns of biochemical recurrence and clinical outcome were investigated. RESULTS: Disease risk was stratified as low-risk in 231 patients, intermediate-risk in 365, and high-risk in 20, respectively. Of these patients, 269 (43.7%) had received hormonal therapy (HT) in combination with LDR-BT, and 80 (13.0%) had received external beam radiotherapy (EBRT). Average dosimetric parameter values with and without EBRT were 95.3% and 94.2% for V100, 132.8 Gy and 164.2 Gy for D90, and 180.6 Gy2 and 173.7 Gy2 for the biologically effective dose. Biochemical recurrence was noted in 14 patients (6.1%) in the low-risk group, 25 patients (6.8%) in the intermediate-risk group, and 6 patients (30.0%) in the high-risk group, respectively. In these cases of biochemical recurrence, 9 (64.3%), 13 (52.0%), and 4 patients (66.7%) in each respective risk group showed signs of clinical recurrence. Five patients (19.2%) with clinical recurrence developed pulmonary metastases, of which 4 were isolated lesions. All tumors responded favorably to subsequent HT. CONCLUSIONS: LDR-BT for biologically aggressive PCa may be linked to possible pulmonary metastasis owing to tumor dissemination during seed implantation. This information is important in planning adequate treatment for these patients.
