2007 Fiscal Year Final Research Report Summary
INDICATION OF CONFORMAL HIGH DOSE RATE IRIDIUM-192 BRACHYTHERAPY FOR HORMONE REFRACTORY PROSTATE CANCER
| Project/Area Number |
18591396
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Radiation science
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| Research Institution | Kawasaki Medical School |
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Principal Investigator |
HIRATSUKA Junichi Kawasaki Medical School, Department of Radiation Oncology, Associate Professor (30192298)
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| Co-Investigator(Kenkyū-buntansha) |
JO Yoshimasa Kawasaki Medical School, Department of Urology, Assistant Professor (40319968)
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| Project Period (FY) |
2006 – 2007
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| Keywords | prostate cancer / hormone refractory prostate cancer / radiotherapy / interstitial brachytherapy / clinical results |
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| Research Abstract |
[INTRODUCTION] The hormone refractory prostate cancer (HRPC) develops hormone resistant prostate cancer with unfavorably prognosis. Several authors have reported some treatment modalities for HRPC, which consists of hormone and/or chemotherapy as systemic therapy. However, there has been still no established effective one. On the other hand, patients with regionally localized HRPC are often referred for radiotherapy to prevent further local progression. Treatment options include (a) no treatment of local progression until urinary obstructive symptoms develop; (b) repeated transurethral resection for urinary obstructive symptoms combined with palliative and short-course radiotherapy; (c) high dose continuous radiotherapy. We have applied high dose rate (HDR) brachytherapy as a boost of external beam radiotherapy (EBRT) to localized prostate cancer since 1997, and in addition to those patients, the patients with locally advanced HRPC have been treated by the modified protocol, too. This
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report is an earlier report on the efficacy of the combination therapy of EBRT and HDR brachytherapy for locally advanced HRPC.
[PATIENTS AND METHODS] Between 1997 and 2006, 38 consecutive patients with hormone refractory adenocarcinoma of the prostate were treated with a combination of EBRT and HDR brachytherapy at the Kawasaki Medical Hospital. Follow up ranged from 1.1 years to 9.8 years with a median follow up of 4.3 years. The length of follow up was calculated from the completion of radiotherapy. The failure free control rates and cause specific survival rate were calculated by the method using Kaplan and Meir Tests of statistical significance were based on the log rank statistic.
[RESULTS] Five-year overall survival rates and PSA failure free survival rates were 78%, and 40%, respectively. According to the univariate actuarial analyses of various potential prognostic factors using PSA failure as end points, initial T stage was only a significant prognostic factor. The patients with Stage B were much better than Stage C in the PSA failure free survival rates. The local therapy as radiotherapy against HRPC is able to control local symptoms such as urinary retention or gross hematuria that tumor growth will cause in the near future, and is able to achieve PSA failure free survival rates in some patients with HRPC. Less
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