Pulmonary Metastases After Low-Dose-Rate Brachytherapy for Localized Prostate Cancer
Kido Masahito, Kuruma Hidetoshi, Sasaki Hiroshi, Miki Kenta, Aoki Manabu, Kimura Takahiro, Takahash Hiroyuki, Kanehira Chihiro, Egawa Shin,
소속 상세정보
( Kido Masahito )
Jikei University Departments of Urology
( Kuruma Hidetoshi )
Jikei University Departments of Urology
( Sasaki Hiroshi )
Jikei University Departments of Urology
( Miki Kenta )
Jikei University Departments of Urology
( Aoki Manabu )
Jikei University Departments of Radiation Oncology
( Kimura Takahiro )
Jikei University Departments of Urology
( Takahash Hiroyuki )
Jikei University Departments of Pathology
( Kanehira Chihiro )
Jikei University Departments of Radiation Oncology
( Egawa Shin )
Jikei University Departments of Urology
KMID : 0358320140550050309
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.
키워드
Brachytherapy; Neoplasm metastasis; Prostate neoplasms
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