Predictive factors of rectal toxicity after permanent iodine-125 seed implantation: Prospective cohort study in 2339 patients.

Brachytherapy 2016 Nov - Dec;15(6):736-745. Epub 2016 Oct 6.

Institutes of Preventive Medicine, Kurosawa Hospital, Takasaki, Japan.

Purpose: To evaluate the incidence and the associated factors of rectal toxicity in patients with prostate cancer undergoing permanent seed implantation (PI) with or without external beam radiation therapy (EBRT) in a nationwide prospective cohort study in Japan (J-POPS) during the first 2 years.

Methods And Materials: A total of 2,339 subjects were available for the analyses. Rectal toxicity was evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events version 3.0.

Results: The 3-year cumulative incidence for grade ≥2 rectal toxicity was 2.88%, 1.76%, and 6.53% in all subjects, PI group and EBRT combination therapy group, respectively. On multivariate analysis, among all subjects, grade ≥2 rectal toxicity was associated with rectal volumes receiving 100% of the prescribed dose (R; p < 0.0001) and EBRT combination therapy (p = 0.0066). R in the PI group (p = 0.0254), and R (p = 0.0011) and interactive planning (p = 0.0267) in the EBRT combination therapy group were also associated with grade ≥2 toxicity. The 3-year cumulative incidence of grade ≥2 rectal toxicity was 3.80% and 1.37% for R ≥ 1 mL and R < 1 mL, respectively, in the PI group (p = 0.0068), and 14.09% and 5.52% for R ≥ 1 mL and R < 1 mL, respectively, in the EBRT combination therapy group (p = 0.0070).

Conclusions: Rectal toxicity was relatively rare in this study compared with previous reports. For Japanese prostate cancer patients, R < 1 mL in both PI and EBRT combination therapy groups and interactive planning in EBRT combination therapy group may be effective in decreasing the incidence of rectal toxicity.

Download full-text PDF

Source
https://linkinghub.elsevier.com/retrieve/pii/S15384721163054
Publisher Site
http://dx.doi.org/10.1016/j.brachy.2016.09.001DOI Listing
July 2017
22 Reads

Publication Analysis

Top Keywords

rectal toxicity
20
grade ≥2
8
prospective cohort
8
cohort study
8
seed implantation
8
≥2 rectal
8
factors rectal
8
rectal
6
toxicity
5
terminology criteria
4
institute common
4
common terminology
4
30results 3-year
4
3-year cumulative
4
version 30results
4
events version
4
adverse events
4
criteria adverse
4
evaluated national
4
2 yearsmethods materials
4

Similar Publications