Current Status of Brachytherapy for Prostate Cancer
Identifieur interne : 000229 ( Pmc/Checkpoint ); précédent : 000228; suivant : 000230Current Status of Brachytherapy for Prostate Cancer
Auteurs : Dong Soo Park [Corée du Sud]Source :
- Korean Journal of Urology [ 2005-6737 ] ; 2012.
Abstract
Brachytherapy was developed to treat prostate cancer 50 years ago. Current advanced techniques using transrectal ultrasonography were established 25 years ago. Transrectal ultrasound (TRUS) has enabled the prostate to be viewed with improved resolution with the use of modern ultrasound machines. Moreover, the development of software that can provide images captured in real time has improved treatment outcomes. Other new radiologic imaging technologies or a combination of magnetic resonance and TRUS could be applied to brachytherapy in the future. The therapeutic value of brachytherapy for early-stage prostate cancer is comparable to that of radical prostatectomy in long-term follow-up. Nevertheless, widespread application of brachytherapy cannot be achieved for several reasons. The treatment outcome of brachytherapy varies according to the skill of the operator and differences in patient selection. Currently, only three radioactive isotopes are available for use in low dose rate prostate brachytherapy: I-125, Pd-103, and Cs-131; therefore, more isotopes should be developed. High dose rate brachytherapy using Ir-192 combined with external beam radiation, which is needed to verify the long-term effects, has been widely applied in high-risk patient groups. Recently, tumor-selective therapy or focal therapy using brachytherapy, which is not possible by surgical extraction, has been developed to maintain the quality of life in selected cases. However, this new application for prostate cancer treatment should be performed cautiously because we do not know the oncological outcome, and it would be an interim treatment method. This technique might evolve into a hybrid of whole-gland treatment and focal therapy.
Url:
DOI: 10.4111/kju.2012.53.11.743
PubMed: 23185664
PubMed Central: 3502731
Affiliations:
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<front><div type="abstract" xml:lang="en"><p>Brachytherapy was developed to treat prostate cancer 50 years ago. Current advanced techniques using transrectal ultrasonography were established 25 years ago. Transrectal ultrasound (TRUS) has enabled the prostate to be viewed with improved resolution with the use of modern ultrasound machines. Moreover, the development of software that can provide images captured in real time has improved treatment outcomes. Other new radiologic imaging technologies or a combination of magnetic resonance and TRUS could be applied to brachytherapy in the future. The therapeutic value of brachytherapy for early-stage prostate cancer is comparable to that of radical prostatectomy in long-term follow-up. Nevertheless, widespread application of brachytherapy cannot be achieved for several reasons. The treatment outcome of brachytherapy varies according to the skill of the operator and differences in patient selection. Currently, only three radioactive isotopes are available for use in low dose rate prostate brachytherapy: I-125, Pd-103, and Cs-131; therefore, more isotopes should be developed. High dose rate brachytherapy using Ir-192 combined with external beam radiation, which is needed to verify the long-term effects, has been widely applied in high-risk patient groups. Recently, tumor-selective therapy or focal therapy using brachytherapy, which is not possible by surgical extraction, has been developed to maintain the quality of life in selected cases. However, this new application for prostate cancer treatment should be performed cautiously because we do not know the oncological outcome, and it would be an interim treatment method. This technique might evolve into a hybrid of whole-gland treatment and focal therapy.</p>
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</TEI>
<pmc article-type="review-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Korean J Urol</journal-id>
<journal-id journal-id-type="iso-abbrev">Korean J Urol</journal-id>
<journal-id journal-id-type="publisher-id">KJU</journal-id>
<journal-title-group><journal-title>Korean Journal of Urology</journal-title>
</journal-title-group>
<issn pub-type="ppub">2005-6737</issn>
<issn pub-type="epub">2005-6745</issn>
<publisher><publisher-name>The Korean Urological Association</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">23185664</article-id>
<article-id pub-id-type="pmc">3502731</article-id>
<article-id pub-id-type="doi">10.4111/kju.2012.53.11.743</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Current Status of Brachytherapy for Prostate Cancer</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Park</surname>
<given-names>Dong Soo</given-names>
</name>
<xref ref-type="aff" rid="A1"></xref>
</contrib>
</contrib-group>
<aff id="A1">Department of Urology, Bundang CHA Hospital, CHA University College of Medicine, Seongnam, Korea.</aff>
<author-notes><corresp>Corresponding Author: Dong Soo Park. Department of Urology, Bundang CHA Hospital, CHA University College of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam 463-712, Korea. TEL: +82-31-780-5352, FAX: +82-31-780-5323, <email>dsparkmd@cha.ac.kr</email>
</corresp>
</author-notes>
<pub-date pub-type="ppub"><month>11</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="epub"><day>14</day>
<month>11</month>
<year>2012</year>
</pub-date>
<volume>53</volume>
<issue>11</issue>
<fpage>743</fpage>
<lpage>749</lpage>
<history><date date-type="received"><day>10</day>
<month>9</month>
<year>2012</year>
</date>
<date date-type="accepted"><day>28</day>
<month>9</month>
<year>2012</year>
</date>
</history>
<permissions><copyright-statement>© The Korean Urological Association, 2012</copyright-statement>
<copyright-year>2012</copyright-year>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0">http://creativecommons.org/licenses/by-nc/3.0</ext-link>
) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
</license>
</permissions>
<abstract><p>Brachytherapy was developed to treat prostate cancer 50 years ago. Current advanced techniques using transrectal ultrasonography were established 25 years ago. Transrectal ultrasound (TRUS) has enabled the prostate to be viewed with improved resolution with the use of modern ultrasound machines. Moreover, the development of software that can provide images captured in real time has improved treatment outcomes. Other new radiologic imaging technologies or a combination of magnetic resonance and TRUS could be applied to brachytherapy in the future. The therapeutic value of brachytherapy for early-stage prostate cancer is comparable to that of radical prostatectomy in long-term follow-up. Nevertheless, widespread application of brachytherapy cannot be achieved for several reasons. The treatment outcome of brachytherapy varies according to the skill of the operator and differences in patient selection. Currently, only three radioactive isotopes are available for use in low dose rate prostate brachytherapy: I-125, Pd-103, and Cs-131; therefore, more isotopes should be developed. High dose rate brachytherapy using Ir-192 combined with external beam radiation, which is needed to verify the long-term effects, has been widely applied in high-risk patient groups. Recently, tumor-selective therapy or focal therapy using brachytherapy, which is not possible by surgical extraction, has been developed to maintain the quality of life in selected cases. However, this new application for prostate cancer treatment should be performed cautiously because we do not know the oncological outcome, and it would be an interim treatment method. This technique might evolve into a hybrid of whole-gland treatment and focal therapy.</p>
</abstract>
<kwd-group><kwd>Brachytherapy</kwd>
<kwd>Neoplasms</kwd>
<kwd>Prostate</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group><fig id="F1" position="float"><label>FIG. 1</label>
<caption><p>Computer software for the intraoperative real-time dosimetry system.</p>
</caption>
<graphic xlink:href="kju-53-743-g001"></graphic>
</fig>
<fig id="F2" position="float"><label>FIG. 2</label>
<caption><p>Implantation is done through the perineum by using template guidance.</p>
</caption>
<graphic xlink:href="kju-53-743-g002"></graphic>
</fig>
<fig id="F3" position="float"><label>FIG. 3</label>
<caption><p>Postimplant dosimetry by computed tomography scan.</p>
</caption>
<graphic xlink:href="kju-53-743-g003"></graphic>
</fig>
<fig id="F4" position="float"><label>FIG. 4</label>
<caption><p>High dose rate temporary prostate brachytherapy (A) and Ir-192 source (B).</p>
</caption>
<graphic xlink:href="kju-53-743-g004"></graphic>
</fig>
<table-wrap id="T1" position="float"><label>TABLE 1</label>
<caption><p>Radionuclides for low dose rate prostate brachytherapy</p>
</caption>
<graphic xlink:href="kju-53-743-i001"></graphic>
<table-wrap-foot><fn><p>EBRT, external beam radiotherapy.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="T2" position="float"><label>TABLE 2</label>
<caption><p>Biochemical outcomes of 125-I low dose rate brachytherapy according to prognostic risk</p>
</caption>
<graphic xlink:href="kju-53-743-i002"></graphic>
</table-wrap>
<table-wrap id="T3" position="float"><label>TABLE 3</label>
<caption><p>Distribution of patients treated with different treatment methods in meta-analysis [<xref ref-type="bibr" rid="B26">26</xref>
]</p>
</caption>
<graphic xlink:href="kju-53-743-i003"></graphic>
<table-wrap-foot><fn><p>Values are presented as no. of patients.</p>
<p>RP, radical prostatectomy; RARP, robot-assisted radical prostatectomy; ADT, androgen deprivation therapy; EBRT, external beam radiotherapy; HIFU, high-intensity focused ultrasound.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
<affiliations><list><country><li>Corée du Sud</li>
</country>
</list>
<tree><country name="Corée du Sud"><noRegion><name sortKey="Park, Dong Soo" sort="Park, Dong Soo" uniqKey="Park D" first="Dong Soo" last="Park">Dong Soo Park</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>
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