LOW DOSE-RATE CONTACT RADIATION THERAPY (BRACHYTHERAPY) FOR PROSTATE CANCER USING DOMESTIC I-125 SEEDS AS A MONOTHERAPY AND COMBINED WITH PELVIC LYMPHADENECTOMY


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Abstract

Introduction In 2014, the incidence of prostate cancer in the Russian Federation was 116.4 per 100,000 population. It is noteworthy that from 2004 to 2014, the proportion of patients with stage I-II prostate cancer increased from 35.5% to 52.5%, while that of patients with stages III and IV disease decreased from 38.4% to 29% and from 22.7% to 16.5%, respectively. All of this allows an increasing number of prostate cancer patients to be treated with radical treatment - low dose-rate brachytherapy. For the first time in this country, we report a clinical trial of low dose-rate brachytherapy for prostate cancer using domestically manufactured I-125 seeds. The successful results of this clinical trial are presented in this article. The aim of this work was to show the clinical efficacy and safety of domestically manufactured I-125 seeds for low dose-rate prostate cancer brachytherapy. Materials and Methods The clinical trial comprised 36 patients with stage T1-T2 prostate cancer. Patients were randomly assigned according to the risk of cancer progression. Low and intermediate risk groups comprised 30 (83.3%) and 6 (16.7%) patients, respectively. Patients of low risk group underwent brachytherapy alone with the minimum therapeutic dose of 145 Gy. I-125 seeds of two activities, 0.55 and 0.35 mCi per seed were used for implantation. Depending on the prostate volume, from 40 to 80 seeds, 57 on average were implanted. Mean implantation time was 85 minutes. In patients of the intermediate risk group brachytherapy was performed in combination with laparoscopic pelvic lymphadenectomy which was carried out 4-5 weeks prior to brachytherapy. Results Follow-up examination at 6 months after implantation showed that PSA decreased in all patients on average by 87% from the baseline. No adverse events were reported. Conclusion The findings of the clinical trials of domestically manufactured I-125 seeds showed they are effective, safe and comply with international standards.

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About the authors

A. D Kaprin

National Medical Radiological Research Center (NMRRC) of Minzdrav of Russia

Academician of the RAS, Dr.Med.Sci., Professor, Director General Moscow

V. N Galkin

A. Tsyb MRRC - branch of the NMRRC of Minzdrav of Russia

Dr.Med.Sci., Professor, Director Obninsk, Russia

S. A Ivanov

A. Tsyb MRRC - branch of the NMRRC of Minzdrav of Russia

Dr.Med.Sci., Deputy Director for Research and Clinical Activities Obninsk, Russia

O. B Karyakin

A. Tsyb MRRC - branch of the NMRRC of Minzdrav of Russia

Dr.Med.Sci., Professor, Hear of the Department of Radiotherapy and Surgical Treatment of Urologic Diseases with a Group of Brachytherapy for Prostate Cancer Obninsk, Russia

V. A Biryukov

A. Tsyb MRRC - branch of the NMRRC of Minzdrav of Russia

PhD, Senior Researcher at the Department of Radiotherapy and Surgical Treatment of Urologic Diseases with a Group of Brachytherapy for Prostate Cancer Obninsk, Russia

A. A Obukhov

A. Tsyb MRRC - branch of the NMRRC of Minzdrav of Russia

Email: obuxov_al@mail.ru
PhD, Senior Researcher at the Department of Radiotherapy and Surgical Treatment of Urologic Diseases with a Group of Brachytherapy for Prostate Cancer Obninsk, Russia

V. A Polyakov

P.A. Herzen Moscow Oncology Research Institute - Branch of the NMRRC of Minzdrav of Russia

PhD, Senior Researcher at the Department of Oncourology Moscow

A. V Chernichenko

P.A. Herzen Moscow Oncology Research Institute - Branch of the NMRRC of Minzdrav of Russia

Dr.Med.Sci., Professor, Head of Department Moscow

A. V Koryakin

N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology - Branch of NMRRC of Minzdrav of Russia

PhD, Senior Researcher Moscow

N. B Borysheva

A. Tsyb MRRC - Branch of the NMRRC of Minzdrav of Russia

PhD Phys. Tech., Head of the Department of Clinical Dosimetry and Topometry Obninsk, Russia

O. G Lepilina

A. Tsyb MRRC - Branch of the NMRRC of Minzdrav of Russia

Staff Memberat the Department of Clinical Dosimetry and Topometry Obninsk, Russia

A. A Goverdovskiy

SRC-Institute of Physics and Power Engineering - ROSATOM State Corporation

Director General Moscow, Russia

References

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  2. European Assosiation of Urology, Guidelines 2016
  3. Лучевая терапия рака предстательной железы. Руководство для врачей / под редакцией А.Ф. Цыба. М., 2010
  4. Богачева В.В., Ахмедова У.А, Петухов А.Д., Колыженков Т.В., Бирюков В.А, Лепилина О.Г., Санин Д.Б., Степаненко В.Ф., Карякин О.Б., Каприн А.Д., Галкин В.Н., Иванов С.А. Локальные дозы облучения медицинского персонала при проведении брахитерапии рака предстательной железы микроисточниками I-125 российского производства. В книге Ломоносов-2016, XXIII Международная конференция студентов, аспирантов и молодых ученых по фундаментальным наукам. 2016. С. 192-194

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