Low-dose brachytherapy for early stage penile cancer: a 20-year single-institution study (73 patients)
Identifieur interne : 000043 ( France/Analysis ); précédent : 000042; suivant : 000044Low-dose brachytherapy for early stage penile cancer: a 20-year single-institution study (73 patients)
Auteurs : A. Cordoba [France] ; A. Escande [France] ; S. Lopez [France] ; L. Mortier [France] ; X. Mirabel [France] ; B. Coche-Déqueant [France] ; E. Lartigau [France]Source :
- Radiation Oncology (London, England) [ 1748-717X ] ; 2016.
Abstract
The aim of this study is to analyze the results of exclusive interstitial brachytherapy (IBT) as a conservative approach in the treatment of penile cancer confined to the glans or the shaft with long-term follow-up in a single institution.
Between July 1992 and November 2013, 73 consecutive patients with non-metastatic invasive penile cancer were treated by Low dose rate (LDR) IBT in our institution. The localization of the primary lesion was glands in 67 patients (91.8 %) and shaft in 6 patients (8.2 %). All 73 patients presented with squamous cell carcinoma with grades of differentiation as follows: 34 patients with grade 1 (44.7 %), 9 patients with grade 2 (11.8 %), 9 patients with grade 3 (11.8 %) and 21 patients unknown (28.8 %). Six patients (7.8 %) presented with in situ carcinoma, 55 patients (75,3 %) presented with T1, 11 patients (15 %) presented with T2, and one patient (1.3 %) presented with Tx. Inguinal nodal dissection was performed in 29 patients (38.2 %); 13 patients (17.8 %) presented with histologically confirmed positive ganglion. After circumcision, IBT was performed using a hypodermic needle. The median dose delivered was 60 Gy (range, 40 to 70 Gy). The median activity of the iridium-192 wire was 1.12 mCi/cm, and the median reference isodose rate was 0.4 Gy/h (range, 0.2–1.2). Patients with histological inguinal metastases received external beam radiotherapy to the selected inguinal affected area with a median dose of 45 Gy (30–55 Gy).
The median follow-up time was 51.8 months (range 34.4 to 68.7). The 5-year overall survival was 82.0 %, with eight deaths from cancer and five non-cancer-related deaths. Disease-specific survival was 91.4 %, relapse-free survival was 64.4 %, and local relapse-free survival as 74 %. Total or partial penile preservation was 87.9 % at 5-years. Complications rates at 5 years were 6.6 % urethral stenosis (five patients), two patients (2.6 %) with pain related to sexual intercourse and four patients (5.3 %) with dysuria grade 2. Five patients (6.8 %) required penile amputation for necrosis.
IBT provides good local control with organ preservation, excellent tolerance and low complication rates in early-stage penile cancers.
Url:
DOI: 10.1186/s13014-016-0676-9
PubMed: 27464910
PubMed Central: 4964092
Affiliations:
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PMC:4964092Le document en format XML
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Cordoba</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Academic Radiation Oncology Department, Oscar Lambret Comprehensive Cancer Center, SIRIC ONCOLille and University Lille 2, 3 rue Fréderic Combemale, Lille, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Academic Radiation Oncology Department, Oscar Lambret Comprehensive Cancer Center, SIRIC ONCOLille and University Lille 2, 3 rue Fréderic Combemale, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Escande, A" sort="Escande, A" uniqKey="Escande A" first="A." last="Escande">A. Escande</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Academic Radiation Oncology Department, Oscar Lambret Comprehensive Cancer Center, SIRIC ONCOLille and University Lille 2, 3 rue Fréderic Combemale, Lille, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Academic Radiation Oncology Department, Oscar Lambret Comprehensive Cancer Center, SIRIC ONCOLille and University Lille 2, 3 rue Fréderic Combemale, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Lopez, S" sort="Lopez, S" uniqKey="Lopez S" first="S." last="Lopez">S. Lopez</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Academic Radiation Oncology Department, Oscar Lambret Comprehensive Cancer Center, SIRIC ONCOLille and University Lille 2, 3 rue Fréderic Combemale, Lille, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Academic Radiation Oncology Department, Oscar Lambret Comprehensive Cancer Center, SIRIC ONCOLille and University Lille 2, 3 rue Fréderic Combemale, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Mortier, L" sort="Mortier, L" uniqKey="Mortier L" first="L." last="Mortier">L. Mortier</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Academic Radiation Oncology Department, Oscar Lambret Comprehensive Cancer Center, SIRIC ONCOLille and University Lille 2, 3 rue Fréderic Combemale, Lille, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Academic Radiation Oncology Department, Oscar Lambret Comprehensive Cancer Center, SIRIC ONCOLille and University Lille 2, 3 rue Fréderic Combemale, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Mirabel, X" sort="Mirabel, X" uniqKey="Mirabel X" first="X." last="Mirabel">X. Mirabel</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Academic Radiation Oncology Department, Oscar Lambret Comprehensive Cancer Center, SIRIC ONCOLille and University Lille 2, 3 rue Fréderic Combemale, Lille, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Academic Radiation Oncology Department, Oscar Lambret Comprehensive Cancer Center, SIRIC ONCOLille and University Lille 2, 3 rue Fréderic Combemale, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Coche Dequeant, B" sort="Coche Dequeant, B" uniqKey="Coche Dequeant B" first="B." last="Coche-Déqueant">B. Coche-Déqueant</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Academic Radiation Oncology Department, Oscar Lambret Comprehensive Cancer Center, SIRIC ONCOLille and University Lille 2, 3 rue Fréderic Combemale, Lille, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Academic Radiation Oncology Department, Oscar Lambret Comprehensive Cancer Center, SIRIC ONCOLille and University Lille 2, 3 rue Fréderic Combemale, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author><author><name sortKey="Lartigau, E" sort="Lartigau, E" uniqKey="Lartigau E" first="E." last="Lartigau">E. Lartigau</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Academic Radiation Oncology Department, Oscar Lambret Comprehensive Cancer Center, SIRIC ONCOLille and University Lille 2, 3 rue Fréderic Combemale, Lille, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Academic Radiation Oncology Department, Oscar Lambret Comprehensive Cancer Center, SIRIC ONCOLille and University Lille 2, 3 rue Fréderic Combemale, Lille</wicri:regionArea><placeName><region type="region">Hauts-de-France</region><region type="old region">Nord-Pas-de-Calais</region><settlement type="city">Lille</settlement></placeName></affiliation></author></analytic><series><title level="j">Radiation Oncology (London, England)</title><idno type="eISSN">1748-717X</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose/objectives</title><p>The aim of this study is to analyze the results of exclusive interstitial brachytherapy (IBT) as a conservative approach in the treatment of penile cancer confined to the glans or the shaft with long-term follow-up in a single institution.</p></sec><sec><title>Materials/methods</title><p>Between July 1992 and November 2013, 73 consecutive patients with non-metastatic invasive penile cancer were treated by Low dose rate (LDR) IBT in our institution. The localization of the primary lesion was glands in 67 patients (91.8 %) and shaft in 6 patients (8.2 %). All 73 patients presented with squamous cell carcinoma with grades of differentiation as follows: 34 patients with grade 1 (44.7 %), 9 patients with grade 2 (11.8 %), 9 patients with grade 3 (11.8 %) and 21 patients unknown (28.8 %). Six patients (7.8 %) presented with in situ carcinoma, 55 patients (75,3 %) presented with T1, 11 patients (15 %) presented with T2, and one patient (1.3 %) presented with Tx. Inguinal nodal dissection was performed in 29 patients (38.2 %); 13 patients (17.8 %) presented with histologically confirmed positive ganglion. After circumcision, IBT was performed using a hypodermic needle. The median dose delivered was 60 Gy (range, 40 to 70 Gy). The median activity of the iridium-192 wire was 1.12 mCi/cm, and the median reference isodose rate was 0.4 Gy/h (range, 0.2–1.2). Patients with histological inguinal metastases received external beam radiotherapy to the selected inguinal affected area with a median dose of 45 Gy (30–55 Gy).</p></sec><sec><title>Results</title><p>The median follow-up time was 51.8 months (range 34.4 to 68.7). The 5-year overall survival was 82.0 %, with eight deaths from cancer and five non-cancer-related deaths. Disease-specific survival was 91.4 %, relapse-free survival was 64.4 %, and local relapse-free survival as 74 %. Total or partial penile preservation was 87.9 % at 5-years. Complications rates at 5 years were 6.6 % urethral stenosis (five patients), two patients (2.6 %) with pain related to sexual intercourse and four patients (5.3 %) with dysuria grade 2. Five patients (6.8 %) required penile amputation for necrosis.</p></sec><sec><title>Conclusions</title><p>IBT provides good local control with organ preservation, excellent tolerance and low complication rates in early-stage penile cancers.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Barnholtz Sloan, Js" uniqKey="Barnholtz Sloan J">JS Barnholtz-Sloan</name></author><author><name sortKey="Maldonado, Jl" uniqKey="Maldonado J">JL Maldonado</name></author><author><name sortKey="Pow Sang, J" uniqKey="Pow Sang J">J Pow-sang</name></author><author><name sortKey="Guiliano, Ar" uniqKey="Guiliano A">AR Guiliano</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bleeker, Mcg" uniqKey="Bleeker M">MCG Bleeker</name></author><author><name sortKey="Heideman, Dam" uniqKey="Heideman D">DAM Heideman</name></author><author><name sortKey="Snijders, Pjf" uniqKey="Snijders P">PJF 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Crevoisier</name></author><author><name sortKey="Slimane, K" uniqKey="Slimane K">K Slimane</name></author><author><name sortKey="Sanfilippo, N" uniqKey="Sanfilippo N">N Sanfilippo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Crook, Jm" uniqKey="Crook J">JM Crook</name></author><author><name sortKey="Jezioranski, J" uniqKey="Jezioranski J">J Jezioranski</name></author><author><name sortKey="Grimard, L" uniqKey="Grimard L">L Grimard</name></author><author><name sortKey="Esche, B" uniqKey="Esche B">B Esche</name></author><author><name sortKey="Pond, G" uniqKey="Pond G">G Pond</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Delaunay, B" uniqKey="Delaunay B">B Delaunay</name></author><author><name sortKey="Soh, Pn" uniqKey="Soh P">PN Soh</name></author><author><name sortKey="Delannes, M" uniqKey="Delannes M">M Delannes</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kamsu Kom, L" uniqKey="Kamsu Kom L">L Kamsu-Kom</name></author><author><name sortKey="Bidault, F" uniqKey="Bidault F">F Bidault</name></author><author><name sortKey="Mazeron, R" uniqKey="Mazeron R">R Mazeron</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sharma, Dn" uniqKey="Sharma D">DN Sharma</name></author><author><name sortKey="Joshi, Np" uniqKey="Joshi N">NP Joshi</name></author><author><name sortKey="Gandhi, Ak" uniqKey="Gandhi A">AK Gandhi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rouscoff, Y" uniqKey="Rouscoff Y">Y Rouscoff</name></author><author><name sortKey="Falk, At" uniqKey="Falk A">AT Falk</name></author><author><name sortKey="Durand, M" uniqKey="Durand M">M Durand</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>France</li></country><region><li>Hauts-de-France</li><li>Nord-Pas-de-Calais</li></region><settlement><li>Lille</li></settlement></list><tree><country name="France"><region name="Hauts-de-France"><name sortKey="Cordoba, A" sort="Cordoba, A" uniqKey="Cordoba A" first="A." last="Cordoba">A. Cordoba</name></region><name sortKey="Coche Dequeant, B" sort="Coche Dequeant, B" uniqKey="Coche Dequeant B" first="B." last="Coche-Déqueant">B. Coche-Déqueant</name><name sortKey="Escande, A" sort="Escande, A" uniqKey="Escande A" first="A." last="Escande">A. Escande</name><name sortKey="Lartigau, E" sort="Lartigau, E" uniqKey="Lartigau E" first="E." last="Lartigau">E. Lartigau</name><name sortKey="Lopez, S" sort="Lopez, S" uniqKey="Lopez S" first="S." last="Lopez">S. Lopez</name><name sortKey="Mirabel, X" sort="Mirabel, X" uniqKey="Mirabel X" first="X." last="Mirabel">X. Mirabel</name><name sortKey="Mortier, L" sort="Mortier, L" uniqKey="Mortier L" first="L." last="Mortier">L. Mortier</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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