Gastrointestinal toxicity of transperineal interstitial prostate brachytherapy.

Journal Article (Journal Article)

PURPOSE: To characterize the severity and time course of rectal toxicity following transperineal prostate brachytherapy using prospectively recorded data, and to determine factors associated with toxicity. METHODS AND MATERIALS: One hundred thirty-four patients with prostate cancer treated with transperineal brachytherapy from 1997 to 1999 had rectal toxicity data available for analysis. Patients with Gleason score (GS) > 6, prostate-specific antigen (PSA) > 6, or stage > T2a were treated initially with external beam radiation therapy followed by brachytherapy boost; patients with none of these features were treated with brachytherapy alone. Both iodine-125 and palladium-103 sources were used, and loaded according to a modified Quimby distribution. At each follow-up, toxicity was recorded according to a modified RTOG gastrointestinal scale. RESULTS: Thirty-nine percent of patients experienced gastrointestinal toxicity, mostly Grade 1. Median duration of symptoms was 6 months. Two patients experienced Grade 3 toxicity, both of whom had minimal symptoms until their 12-month follow-up. There was no Grade 4 or 5 toxicity. The addition of external beam radiation therapy (p = 0.003), higher clinical stage (p = 0.006), and Caucasian race (p = 0.01) were associated with increased incidence of toxicity. CONCLUSION: Most patients with rectal toxicity have very mild symptoms. There is a small risk of severe late toxicity. External beam radiation, higher stage, and race are associated with toxicity.

Full Text

Duke Authors

Cited Authors

  • Kang, SK; Chou, RH; Dodge, RK; Clough, RW; Kang, H-SL; Hahn, CA; Whitehurst, AW; Buckley, NJ; Kim, JH; Joyner, RE; Montana, GS; Ingram, SS; Anscher, MS

Published Date

  • May 1, 2002

Published In

Volume / Issue

  • 53 / 1

Start / End Page

  • 99 - 103

PubMed ID

  • 12007947

International Standard Serial Number (ISSN)

  • 0360-3016

Digital Object Identifier (DOI)

  • 10.1016/s0360-3016(01)02811-5


  • eng

Conference Location

  • United States