HDR afterloading therapy delivers excellent results
WPZ presented its latest study at EAU in Barcelona
Barcelona 18.4.2010 - - Prostate cancer patients with a locally advanced tumor benefit from combined radiotherapy. The tumour is irradiated both from the inside by HDR brachytherapy and from the outside. This is shown by a study of the West German Prostate Center, which was recently presented at the 2010 annual meeting of the European Association of Urology (EAU) in Barcelona.
While permanent seed implantation is mainly used as the sole therapy for low-risk tumors, HDR brachytherapy in combination with external radiation therapy is successfully applied in patients with locally advanced prostate carcinoma. The advantage compared to radiation alone is that the prostate can be irradiated with a high dose and at the same time the radiation dose to the surrounding organs remains as low as possible. The afterloading procedure is usually combined with external irradiation. This ensures that the peripheral areas of the prostate, where tumor cells can break through the prostate capsule, are also irradiated,"explained Dr. Pedram Derakhshani. However, the radiation dose of the external irradiation can be significantly reduced due to the additional and high-dose internal irradiation. Radiation-related complications of the rectum and urinary bladder are greatly reduced for the patient.
Quality of life is maintained
A recent study by the West German Prostate Center has now shown that HDR brachytherapy for prostate carcinoma with a medium or high risk profile leads to an excellent healing rate and quality of life with low side effects due to radiation exposure. Between 2003 and 2008, a total of 692 patients were treated with afterloading technology as a "boost" in combination with external radiation therapy. PSA values, urinary function, urinary incontinence and sexual functions were recorded, as well as the effects of treatment on quality of life using validated questionnaires.
The results are clear: the PSA value in patients with medium and high risk decreased from 12 ng/ml to 0.19 ng/ml after an average of 36 months. The biochemical absence of recurrence (PRFS) as a measure of the effectiveness of the treatment after 3 years was about 80 percent. Complications requiring treatment occurred extremely rarely after treatment. Occasionally, local irritation of the bladder and intestine may occur. Immediately after the procedure, many patients complain about frequent urination,"emphasized the Cologne urologist. However, the symptoms usually disappear completely after 3 to 6 months. The figures are reflected in the patients' quality of life: the general state of health remained stable and returned to the pre-treatment level.
- A further plus point: the patients are able to resume professional and private activities after only a few days. Derakhshani:"HDR brachytherapy is a small, gentle procedure that is usually carried out on a short-term inpatient basis and represents only a minor burden for the patient.