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ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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1/2024
vol. 16
 
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abstract:
Original paper

Safety of high-dose-rate brachytherapy in patients with prostate cancer and inflammatory bowel disease: A case series

Horatio Thomas
1
,
Jie Jane Chen
1
,
Haitham Shaheen
2
,
Ali Sabbagh
1
,
Hasan Abdul-Baki
1
,
Oi Wai Chau
1
,
Nauman Malik
3
,
Alan Ayoub
4
,
Comron Hassanzadeh
5
,
I-Chow Hsu
1
,
Osama Mohamad
1, 6

  1. Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA
  2. Department of Clinical Oncology, Faculty of Medicine, Suez Canal University, Egypt
  3. Department of Radiation Oncology, University of Toronto, Toronto, Canada
  4. University of Zagreb School of Medicine, Zagreb, Croatia
  5. Department of Radiation Oncology, MD Anderson Cancer Center, Houston, USA
  6. Department of Urology, University of California San Francisco, San Francisco, CA, USA
J Contemp Brachytherapy 2024; 16, 1: 1–5
DOI: https://doi.org/10.5114/jcb.2024.135645
Online publish date: 2024/02/23
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Introduction:
Inflammatory bowel disease (IBD) is a relative contraindication to external beam radiation therapy (EBRT) for prostate cancer patients due to fear of increased risk of gastrointestinal (GI) toxicity. High-dose-rate (HDR) brachytherapy, capable of minimizing radiation dose to surrounding tissues, is a feasible alternative. Given limited data, this study examined the safety profile of HDR brachytherapy in this setting.

Material and methods:
We conducted a retrospective review of patients with localized prostate cancer and IBD treated with HDR brachytherapy at the University of California San Francisco (UCSF), between 2010 and 2022. Eligibility criteria included biopsy-proven prostate cancer, no distant metastases, absence of prior pelvic radiotherapy, IBD diagnosis, and at least one follow-up visit post-treatment.

Results:
Eleven patients were included, with a median follow-up of 28.7 months. The median dose administered was 2700 cGy (range, 1500-3150 cGy) over 2 fractions (range, 1-3 fractions). Two patients also received EBRT. Rectal spacers (SpaceOAR) were applied in seven patients. All patients experienced acute genitourinary (GU) toxicity, ten of which were grade 1 and one was grade 2. Eight patients experienced late grade 1 GU toxicity, and three patients had late grade 2 GU toxicity. GI toxicities were similarly low-grade, with six grade 1 acute toxicity, no grade 2 or higher acute toxicity, six grade 1 late toxicity, and one late grade 2 GI toxicity. No grade 3 or higher acute or late GI or GU toxicities were reported.

Conclusions:
HDR brachytherapy appears to be a safe and tolerable treatment modality for patients with prostate cancer and IBD, with minimal acute and late GI and GU toxicity. These findings warrant multi-institutional validation due to small sample size.

keywords:

high-dose-rate, HDR, brachytherapy, prostate cancer, inflammatory bowel disease

  
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