Difference in the rate of rectal complications following prostate brachytherapy based on the prostate-rectum distance and the prostate longitudinal length among early prostate cancer patients.
10.4111/kju.2015.56.9.637
- Author:
Moon Hyung KANG
1
;
Young Dong YU
;
Hyun Soo SHIN
;
Jong Jin OH
;
Dong Soo PARK
Author Information
1. Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea. dsparkmd@cha.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Brachytherapy;
Proctitis;
Prostatic neoplasms
- MeSH:
Aged;
Brachytherapy/*adverse effects;
Carcinoma/*radiotherapy;
Colonoscopy;
Humans;
Magnetic Resonance Imaging;
Male;
Middle Aged;
Organ Size;
Proctitis/diagnosis/*etiology;
Prostate/*pathology;
Prostatic Neoplasms/*radiotherapy;
Radiation Injuries/diagnosis/*etiology;
Severity of Illness Index
- From:Korean Journal of Urology
2015;56(9):637-643
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To investigate the difference in rectal complications rate following prostate low dose rate (LDR) brachytherapy based on prostate-rectum distance and prostate longitudinal length among early prostate cancer patients. MATERIALS AND METHODS: From March 2008 to February 2013, 245 prostate cancer patients with a Gleason score < or =7 were treated with 125-I LDR brachytherapy. Among them, 178 patients with prostate volume 20-35 mL and a follow-up period > or =6 months were evaluated for radiation proctitis. Magnetic resonance imaging (MRI) was performed for a prebrachytherapy evaluation, and prostate-rectum distance and prostate longitudinal length were measured. The radiation proctitis was confirmed and graded via colonoscopy based on the radiation therapy oncology group (RTOG) toxicity criteria. RESULTS: Twenty-three patients received a colonoscopy for proctitis evaluation, and 12 were identified as grade 1 on the RTOG scale. Nine patients were diagnosed as grade 2 and 2 patients were grade 3. No patient developed grade 4 proctitis. The rectal-complication group had a mean prostate-rectum distance of 2.51+/-0.16 mm, while non-rectal-complication control group had 3.32+/-0.31 mm. The grade 1 proctitis patients had a mean prostate-rectum distance of 2.80+/-0.15 mm, which was significantly longer than 2.12+/-0.31 mm of grades 2 and 3 patient groups (p=0.045). All 11 patients of grades 2 and 3 had a prostate longitudinal length of 35.22+/-2.50 mm, which was longer than group 1, but the difference was not statistically significant (p=0.214). CONCLUSIONS: As the prostate-rectum distance increased, fewer postimplantation rectal symptoms were observed. Patients with a shorter prostate-rectum distance in MRI should receive modified implantation techniques or radical prostatectomy.
