Clinical use of high dose-rate brachytherapy in treatment of patients with localized prostate cancer and infravesical obstruction

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Abstract

Background. High dose-rate brachytherapy is a new method of interstitial radiation therapy for treatment of localized prostate cancer. The difference from low dose therapy is temporary implantation of radiation sources with targeted high dose-rate irradiation of the affected organ.

Aim. To evaluate 3-year effectiveness and safety of high dose-rate brachytherapy in patients with infravesical obstruction. Materials and methods. Between January of 2017 and December of 2019 at the Central Clinical Hospital “RZD-medicine”, 49 patients  (mean age 67.8 ± 7.5 years) with verified prostate  cancer diagnosis underwent high dose-rate brachytherapy in the regimen of 2 sessions of 15 Gy with 192Ir source. The inclusion criteria were disease stage ≤сТ2с, Gleason score ≤7. Patients were divided into 2 groups: 1st – patients with incidental prostate cancer (n = 21) who previously (more than 6 months ago, mean time 9.4 ± 2.4 months) underwent transurethral prostatectomy; 2nd – patients with verified prostate cancer (mean prostate volume 56 cm3) and obstructive symptoms without previous transurethral prostatectomy (n = 28).

Results. In both groups, no intraoperative complications were observed. In 6 (28 %) patients of the 1st group and 2 patients of the 2nd group, grade II genitourinary toxicity in the form of moderate dysuria and nocturia was observed. Acute gastrointestinal  toxicity was observed in 3 (14 %) patients of the 1st group, in the 2nd group such complications were absent. In the 2nd group during the postoperative period after the 2nd session, 4 patients (14 %) experienced acute urinary retention requiring cystostomy.

Conclusion. High dose-rate brachytherapy is a safe and effective radical treatment method for patients with localized prostate cancer with obstructive symptoms who have contraindications for surgical treatment.

About the authors

D. M. Yagudaev

Central Clinical Hospital “RZD-Medicine”; Peoples’ Friendship University of Russia named after Patrice Lumumba

Author for correspondence.
Email: y.d.m.21@mail.ru
ORCID iD: 0000-0002-5949-6915

Daniel M. Yagudaev.

2 Budayskaya St., Moscow 129128; 6 Miklukho-Maklaya St., Moscow 117198

Russian Federation

A. G. Martov

D.D. Pletnev City Clinical Hospital, Moscow Healthcare Department; State Scientific Center of the Russian Federation – A.I. Burnazyan Federal Medical Biophysical Center, Federal Medical and Biological Agency; M.V. Lomonosov Moscow State University

ORCID iD: 0000-0001-6324-6110

32 11th Parkovaya St., Moscow 105077; 23 Marshala Novikova St., Moscow 123098; 1 Leninskie Gory, Moscow 119991

Russian Federation

D. V. Ergakov

D.D. Pletnev City Clinical Hospital, Moscow Healthcare Department; State Scientific Center of the Russian Federation – A.I. Burnazyan Federal Medical Biophysical Center, Federal Medical and Biological Agency

ORCID iD: 0000-0003-1682-7208

32 11th Parkovaya St., Moscow 105077; 23 Marshala Novikova St., Moscow 123098

Russian Federation

D. D. Yagudaev

D.D. Pletnev City Clinical Hospital, Moscow Healthcare Department; State Scientific Center of the Russian Federation – A.I. Burnazyan Federal Medical Biophysical Center, Federal Medical and Biological Agency

ORCID iD: 0000-0001-5059-2727

32 11th Parkovaya St., Moscow 105077; 23 Marshala Novikova St., Moscow 123098

Russian Federation

Z. A. Kadyrov

Central Clinical Hospital “RZD-Medicine”; Peoples’ Friendship University of Russia named after Patrice Lumumba

ORCID iD: 0000-0002-1108-8138

2 Budayskaya St., Moscow 129128; 6 Miklukho-Maklaya St., Moscow 117198

Russian Federation

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