High dose rate brachytherapy for prostate cancer: A prospective toxicity evaluation of a one day schedule including two 13.5 Gy fractions

Publication date: Available online 3 April 2018
Source:Radiotherapy and Oncology
Author(s): Gorka Nagore, Jose Luis Lopez Guerra, Evita Krumina, Mark Lagos, Beatriz Ovalles, Antonio Miró, Lourdes Beltran, Emilia Gómez, Juan Manuel Praena-Fernandez, Eleonor Rivin del Campo, Ignacio Azinovic, Alfonso Gomez-Iturriaga
Background and purposeHigh dose-rate (HDR) brachytherapy (BT) provides a highly conformal method of dose delivery to the prostate. The purpose of this study is to prospectively determine the toxicity of the treatment protocol of 13.5 Gy × 2 fractions.Materials and methodsFrom 2010 through 2017, 119 patients with low (71%) or intermediate-risk prostate cancer were prospectively treated in a single institute with HDR-BT at 13.5 Gy × 2 fractions within one day. Median follow-up time was 4.4 years.ResultsActuarial rates of no biochemical evidence of disease, overall survival and metastasis-free survival for all patients were 96%,98% and 98%, respectively. The cumulative incidence of acute grade 2 and 3 genitourinary (GU) toxicity was 9% and 2%, respectively. The corresponding incidences of late GU toxicity were 18% and 1%. No grade ≥4 of either type of toxicity was detected. Multivariate analysis showed that having higher international prostate symptom score (IPSS; P = 0.041) or higher V200 (P = 0.013) was associated with a higher risk of experiencing any grade of acute GU toxicity. In addition, patients having a higher IPSS (P = 0.019) or a higher V150 (P = 0.033) were associated with a higher grade >1 acute GU toxicity.ConclusionsThe findings of this study show that HDR-BT 13.5 Gy × 2 as monotherapy was safe and effective for prostate cancer patients with low-intermediate risk.



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ENLIGHT: European network for Light ion hadron therapy

Publication date: Available online 3 April 2018
Source:Radiotherapy and Oncology
Author(s): Manjit Dosanjh, Ugo Amaldi, Ramona Mayer, Richard Poetter
The European Network for Light Ion Hadron Therapy (ENLIGHT) was established in 2002 following various European particle therapy network initiatives during the 1980s and 1990s (e.g. EORTC task group, EULIMA/PIMMS accelerator design). ENLIGHT started its work on major topics related to hadron therapy (HT), such as patient selection, clinical trials, technology, radiobiology, imaging and health economics. It was initiated through CERN and ESTRO and dealt with various disciplines such as (medical) physics and engineering, radiation biology and radiation oncology. ENLIGHT was funded until 2005 through the EC FP5 programme. A regular annual meeting structure was started in 2002 and continues until today bringing together the various disciplines and projects and institutions in the field of HT at different European places for regular exchange of information on best practices and research and development. Starting in 2006 ENLIGHT coordination was continued through CERN in collaboration with ESTRO and other partners involved in HT. Major projects within the EC FP7 programme (2008–2014) were launched for R&D and transnational access (ULICE, ENVISION) and education and training networks (Marie Curie ITNs: PARTNER, ENTERVISION). These projects were instrumental for the strengthening of the field of hadron therapy.With the start of 4 European carbon ion and proton centres and the upcoming numerous European proton therapy centres, the future scope of ENLIGHT will focus on strengthening current and developing European particle therapy research, multidisciplinary education and training and general R&D in technology and biology with annual meetings and a continuously strong CERN support. Collaboration with the European Particle Therapy Network (EPTN) and other similar networks will be pursued.



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PROGRAD – An observational study of the prognosis of inpatients evaluated for palliative radiotherapy

Publication date: Available online 3 April 2018
Source:Radiotherapy and Oncology
Author(s): Andre Tsin Chih Chen, Geovanne Pedro Mauro, Flavia Gabrielli, Cristiane de Lacerda Gonçalves Chaves, Igor Castro, Karina Moutinho Vasconcelos, Milena Reis, Thalita Saraiva, Heloisa Andrade de Carvalho
Background and purposeLow-and-middle-income countries have resource constraints and waiting lists for radiotherapy (RT). In this context, we sought to determine the survival of inpatients evaluated for palliative RT in a large referral cancer center in Brazil.Material and methodsFrom November 2014 through December 2015, we enrolled 333 inpatients with palliative RT evaluation requests in this prospective observational study. We applied Palliative Prognostic Index (PPI) and Survival Prediction Score using Number of Risk Factors (NRF). Primary endpoint was overall survival. Secondary endpoints were survival by PPI and NRF. (ClinicalTrials.gov number, NCT02312791).ResultsMedian survival (MS) for the entire cohort was 73 days. PPI ≤2 had MS of 120 days; PPI 2.5–4 had MS of 55 days (HR 1.84; 95% CI, 1.07–3.16); PPI >4 had MS of 39 days (HR 3.45; 95% CI, 2.07–5.74) (p < .0001). NRF 0–1 had MS of 129 days; NRF 2 had MS of 73 days (HR 1.74; 95% CI 0.89–3.38); NRF 3 had MS of 40 days (HR 2.95; 95% CI, 1.50–5.78) (p < .0001).ConclusionInpatients with palliative RT requests seem to have an overall poor survival. PPI and NRF can define subgroups with different prognosis. This could help hospitals and healthcare systems to standardize criteria for prioritization and contribute for fairness.



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Copyright

Publication date: May 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 3





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Contributors

Publication date: May 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 3





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Contents

Publication date: May 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 3





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CME Accreditation Page

Publication date: May 2018
Source:Radiologic Clinics of North America, Volume 56, Issue 3





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