Interactive-plan technique conquers the disadvantages of volume-reducing hormone therapy in 125I permanent implantation for localized prostate cancer

Int J Clin Oncol. 2009 Feb;14(1):53-5. doi: 10.1007/s10147-008-0799-6. Epub 2009 Feb 20.

Abstract

Background: The purpose of this study was to assess the impact of hormone therapy on post-implant dosimetry in patients in whom pre-plan and interactive-plan techniques were used for transperineal brachytherapy against prostatic cancer.

Methods: The subjects comprised 244 patients treated using (125)I seed implantation as monotherapy. The prescribed dose to the periphery of the prostate was 145 Gy. The pre-plan technique was used for 116 patients, and the interactive-plan technique for 128 patients. Hormone therapy was used in 71 patients (29.1%). The D90 (dose to 90% of prostate volume) of post-implant computed tomography (CT) analysis was assessed in both groups. In addition, the ratio of post-implant CT volume to preoperative ultrasonography (US) volume was assessed.

Results: In the pre-plan group, D90 was significantly lower for patients who received hormone therapy than for those who did not (P = 0.035). However, in the interactive-plan group, D90 did not differ between patients with and without hormone therapy (P = 0.467). The CT-to-US prostate volume ratio was 1.022 for patients who received hormone therapy and 0.960 for patients who did not (P = 0.021).

Conclusion: Post-traumatic swelling following implantation is increased by cessation of hormone therapy and may reduce D90. However, the present results suggest that the interactive-plan technique overcomes this disadvantage of hormone therapy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Hormonal / administration & dosage*
  • Brachytherapy*
  • Chemotherapy, Adjuvant
  • Drug Administration Schedule
  • Humans
  • Iodine Radioisotopes / therapeutic use*
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Organ Size
  • Prostate / drug effects*
  • Prostate / pathology
  • Prostate / radiation effects*
  • Prostatic Neoplasms / drug therapy*
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / radiotherapy*
  • Radiation Dosage
  • Radiotherapy Planning, Computer-Assisted*
  • Radiotherapy, Adjuvant
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography

Substances

  • Antineoplastic Agents, Hormonal
  • Iodine Radioisotopes