Abstract
We evaluated the predictive factors of acute urinary morbidity (AUM) after prostate brachytherapy. From November 2005 to January 2007, 62 patients with localized prostate cancer were treated using brachytherapy. The 125Iodine (125I) seed-delivering method was a modified peripheral pattern. The prescribed dose was 144 Gy. Urinary morbidity was scored at 3 months after implantation. The clinical and treatment parameters were analysed for correlation with AUM. In particular, in this study, Du90 (the minimal dose received by 90% of the urethra), Dup90 (the minimal dose received by 90% of the proximal half of the urethra on the bladder side) and Dud90 (the minimal dose received by 90% of the distal half of the urethra on the penile side) were analysed. We found that 43 patients (69.4%) experienced acute urinary symptoms at 3 months after implantation. Of them, 40 patients had Grade 1 AUM, one patient had Grade 2 pain, and two patients had Grade 2 urinary frequency. None of the patients had ≥Grade 3. Univariate and multivariate analysis revealed that Du90 and Dup90 were significantly correlated with AUM. In this study, Du90 and Dup90 were the most significant predictors of AUM after prostate brachytherapy.
Highlights
In Japan, the number of patients identified with early-stage prostate cancer has increased along with the rise in prostatespecific antigen (PSA) examinations
Several groups have reported that prostate brachytherapy (PB) resulted in excellent outcomes for T1–2 prostate cancer patients [1,2,3,4,5]
Salem et al reported that a V150 of the urethra >40% was a significant predictor of acute urinary morbidity (AUM) [11]
Summary
In Japan, the number of patients identified with early-stage prostate cancer has increased along with the rise in prostatespecific antigen (PSA) examinations. Some authors have reported a correlation between AUM and the dose of urethra in prostate gland [11,12,13]. Desai et al reported that the urethral dose was significantly correlated with the frequency of AUM [12]. Akimoto et al reported a correlation between the severity of AUM and the urethral dose in high-dose-rate (HDR) brachytherapy for prostate cancer [13]. Some studies have demonstrated that the urethral dose is correlated with the occurrence of AUM, there are few reports on the relationship between the doses to the segments of the urethra and AUM [14]. We evaluated the predictive factors of AUM, focusing on the urethral segmental doses
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