Low-dose brachytherapy for early stage penile cancer: a 20-year single-institution study (73 patients)
Identifieur interne : 000E30 ( Pmc/Curation ); précédent : 000E29; suivant : 000E31Low-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
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<series><title level="j">Radiation Oncology (London, England)</title>
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<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>
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<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>
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</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>
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</analytic>
</biblStruct>
</listBibl>
</div1>
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</TEI>
<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Radiat Oncol</journal-id>
<journal-id journal-id-type="iso-abbrev">Radiat Oncol</journal-id>
<journal-title-group><journal-title>Radiation Oncology (London, England)</journal-title>
</journal-title-group>
<issn pub-type="epub">1748-717X</issn>
<publisher><publisher-name>BioMed Central</publisher-name>
<publisher-loc>London</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">27464910</article-id>
<article-id pub-id-type="pmc">4964092</article-id>
<article-id pub-id-type="publisher-id">676</article-id>
<article-id pub-id-type="doi">10.1186/s13014-016-0676-9</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Research</subject>
</subj-group>
</article-categories>
<title-group><article-title>Low-dose brachytherapy for early stage penile cancer: a 20-year single-institution study (73 patients)</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Cordoba</surname>
<given-names>A.</given-names>
</name>
<address><phone>+ 33 (0)3 20 29 59 11</phone>
<email>a-cordoba@o-lambret.fr</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Escande</surname>
<given-names>A.</given-names>
</name>
<address><email>alexandre.escande@gmail.com</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lopez</surname>
<given-names>S.</given-names>
</name>
<address><email>a-cordoba@o-lambret.fr</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mortier</surname>
<given-names>L.</given-names>
</name>
<address><email>laurent.mortier@chru-lille.fr</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Mirabel</surname>
<given-names>X.</given-names>
</name>
<address><email>x-mirabel@o-lambret.fr</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Coche-Déqueant</surname>
<given-names>B.</given-names>
</name>
<address><email>b-coche@o-lambret.fr</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<contrib contrib-type="author"><name><surname>Lartigau</surname>
<given-names>E.</given-names>
</name>
<address><email>e-lartigau@o-lambre.fr</email>
</address>
<xref ref-type="aff" rid="Aff1"></xref>
</contrib>
<aff id="Aff1">Academic Radiation Oncology Department, Oscar Lambret Comprehensive Cancer Center, SIRIC ONCOLille and University Lille 2, 3 rue Fréderic Combemale, Lille, France</aff>
</contrib-group>
<pub-date pub-type="epub"><day>27</day>
<month>7</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>27</day>
<month>7</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="collection"><year>2016</year>
</pub-date>
<volume>11</volume>
<elocation-id>96</elocation-id>
<history><date date-type="received"><day>13</day>
<month>5</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>22</day>
<month>7</month>
<year>2016</year>
</date>
</history>
<permissions><copyright-statement>© The Author(s). 2016</copyright-statement>
<license license-type="OpenAccess"><license-p><bold>Open Access</bold>
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/publicdomain/zero/1.0/">http://creativecommons.org/publicdomain/zero/1.0/</ext-link>
) applies to the data made available in this article, unless otherwise stated.</license-p>
</license>
</permissions>
<abstract id="Abs1"><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>
</abstract>
<kwd-group xml:lang="en"><title>Keywords</title>
<kwd>Penile cancer</kwd>
<kwd>Interstitial brachytherapy</kwd>
<kwd>Local control</kwd>
</kwd-group>
<custom-meta-group><custom-meta><meta-name>issue-copyright-statement</meta-name>
<meta-value>© The Author(s) 2016</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
</record>
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