High dose rate brachytherapy boost for prostate cancer

A systematic review

Nicholas Zaorsky, Laura A. Doyle, Kosj Yamoah, Jocelyn A. Andrel, Edouard J. Trabulsi, Mark D. Hurwitz, Adam P. Dicker, Robert B. Den

Research output: Contribution to journalReview article

40 Citations (Scopus)

Abstract

Studies of dose-escalated external beam radiation therapy (EBRT) and low dose rate brachytherapy (LDR-BT) have shown excellent rates of tumor control and cancer specific survival. Moreover, LDR-BT combined with EBRT (i.e. "LDR-BT boost") is hypothesized to improve local control. While phase II trials with LDR-BT boost have produced mature data of outcomes and toxicities, high dose rate (HDR)-BT has been growing in popularity as an alternative boost therapy. Boost from HDR-BT has theoretical advantages over LDR-BT, including improved cancer cell death and better dose distribution from customization of catheter dwell times, locations, and inverse dose optimization. Freedom from biochemical failure rates at five years for low-, intermediate-, high-risk, and locally advanced patients have generally been 85-100%, 80-98%, 59-96%, and 34-85%, respectively. Late Radiation Therapy Oncology Group grade 3-4 toxicities have also been encouraging with <6% of patients experiencing any toxicity. Limitations of current HDR-BT boost studies include reports of only single-institution experiences, and unrefined reports of toxicity or patient quality of life. Comparative effectiveness research will help guide clinicians in selecting the most appropriate treatment option for individual patients based on risk-stratification, expected outcomes, toxicities, quality of life, and cost.

Original languageEnglish (US)
Pages (from-to)414-425
Number of pages12
JournalCancer Treatment Reviews
Volume40
Issue number3
DOIs
StatePublished - Apr 1 2014

Fingerprint

Brachytherapy
Prostatic Neoplasms
Radiotherapy
Comparative Effectiveness Research
Quality of Life
Neoplasms
Radiation Oncology
Complementary Therapies
Cell Death
Catheters
Costs and Cost Analysis
Survival

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Zaorsky, N., Doyle, L. A., Yamoah, K., Andrel, J. A., Trabulsi, E. J., Hurwitz, M. D., ... Den, R. B. (2014). High dose rate brachytherapy boost for prostate cancer: A systematic review. Cancer Treatment Reviews, 40(3), 414-425. https://doi.org/10.1016/j.ctrv.2013.10.006
Zaorsky, Nicholas ; Doyle, Laura A. ; Yamoah, Kosj ; Andrel, Jocelyn A. ; Trabulsi, Edouard J. ; Hurwitz, Mark D. ; Dicker, Adam P. ; Den, Robert B. / High dose rate brachytherapy boost for prostate cancer : A systematic review. In: Cancer Treatment Reviews. 2014 ; Vol. 40, No. 3. pp. 414-425.
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Zaorsky, N, Doyle, LA, Yamoah, K, Andrel, JA, Trabulsi, EJ, Hurwitz, MD, Dicker, AP & Den, RB 2014, 'High dose rate brachytherapy boost for prostate cancer: A systematic review', Cancer Treatment Reviews, vol. 40, no. 3, pp. 414-425. https://doi.org/10.1016/j.ctrv.2013.10.006

High dose rate brachytherapy boost for prostate cancer : A systematic review. / Zaorsky, Nicholas; Doyle, Laura A.; Yamoah, Kosj; Andrel, Jocelyn A.; Trabulsi, Edouard J.; Hurwitz, Mark D.; Dicker, Adam P.; Den, Robert B.

In: Cancer Treatment Reviews, Vol. 40, No. 3, 01.04.2014, p. 414-425.

Research output: Contribution to journalReview article

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T1 - High dose rate brachytherapy boost for prostate cancer

T2 - A systematic review

AU - Zaorsky, Nicholas

AU - Doyle, Laura A.

AU - Yamoah, Kosj

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AU - Trabulsi, Edouard J.

AU - Hurwitz, Mark D.

AU - Dicker, Adam P.

AU - Den, Robert B.

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N2 - Studies of dose-escalated external beam radiation therapy (EBRT) and low dose rate brachytherapy (LDR-BT) have shown excellent rates of tumor control and cancer specific survival. Moreover, LDR-BT combined with EBRT (i.e. "LDR-BT boost") is hypothesized to improve local control. While phase II trials with LDR-BT boost have produced mature data of outcomes and toxicities, high dose rate (HDR)-BT has been growing in popularity as an alternative boost therapy. Boost from HDR-BT has theoretical advantages over LDR-BT, including improved cancer cell death and better dose distribution from customization of catheter dwell times, locations, and inverse dose optimization. Freedom from biochemical failure rates at five years for low-, intermediate-, high-risk, and locally advanced patients have generally been 85-100%, 80-98%, 59-96%, and 34-85%, respectively. Late Radiation Therapy Oncology Group grade 3-4 toxicities have also been encouraging with <6% of patients experiencing any toxicity. Limitations of current HDR-BT boost studies include reports of only single-institution experiences, and unrefined reports of toxicity or patient quality of life. Comparative effectiveness research will help guide clinicians in selecting the most appropriate treatment option for individual patients based on risk-stratification, expected outcomes, toxicities, quality of life, and cost.

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