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One-step customized transurethral resection of the prostate and permanent implant brachytherapy for selected prostate cancer patients: technically feasible but too toxic.
Brachytherapy. 2011 Jan-Feb; 10(1):29-34.B

Abstract

INTRODUCTION

Patients with prominent median lobe hyperplasia and/or high International Prostate Symptom Score (IPSS) are often contraindicated for prostate brachytherapy, mainly because of the risk of post-implant urinary retention. We evaluated an approach combining in the same operative step a limited transurethral resection (TURP) of the median lobe, immediately followed by permanent implant-free seed brachytherapy.

METHODS AND MATERIALS

From January 2007 to November 2008, 22 patients underwent a customized limited TURP of their median lobe immediately before brachytherapy. All patients fulfilled our criteria for permanent implant brachytherapy, but presented with a more or less prominent median lobe and/or a high IPSS.

RESULTS

The procedure appeared to be technically feasible, with only 0.3% of migrating seeds, a mean post-implant D90 of 173.4 Gy and a mean post-implant V100 of 96.6%. However, 5 patients (23%) experienced a urinary retention, with two patients having to undergo a complementary post-implant TURP. Moreover, urinary toxicity was more pronounced than in our current experience, with high IPSS at 2 months (mean 19.2) and 6 months (mean 15.8).

CONCLUSION

Although technically feasible, with relatively few migrating seeds and satisfactory post-implant dosimetric parameters, one-step TURP and brachytherapy was found to be poorly tolerated, with higher than usual urinary retention and urinary toxicity rates. Considering those results, our group is presently evaluating a two-step procedure, with a customized TURP followed after 4-6 months by brachytherapy.

Authors+Show Affiliations

Department of Radiotherapy, Institut Curie, 26 rue d’Ulm, Paris, France. Jean-marc.cosset@curie.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

21251622

Citation

Cosset, Jean-Marc, et al. "One-step Customized Transurethral Resection of the Prostate and Permanent Implant Brachytherapy for Selected Prostate Cancer Patients: Technically Feasible but Too Toxic." Brachytherapy, vol. 10, no. 1, 2011, pp. 29-34.
Cosset JM, Barret E, Castro-Pena P, et al. One-step customized transurethral resection of the prostate and permanent implant brachytherapy for selected prostate cancer patients: technically feasible but too toxic. Brachytherapy. 2011;10(1):29-34.
Cosset, J. M., Barret, E., Castro-Pena, P., Cathelineau, X., Galiano, M., Rozet, F., Pierrat, N., Timbert, M., & Vallancien, G. (2011). One-step customized transurethral resection of the prostate and permanent implant brachytherapy for selected prostate cancer patients: technically feasible but too toxic. Brachytherapy, 10(1), 29-34. https://doi.org/10.1016/j.brachy.2010.11.005
Cosset JM, et al. One-step Customized Transurethral Resection of the Prostate and Permanent Implant Brachytherapy for Selected Prostate Cancer Patients: Technically Feasible but Too Toxic. Brachytherapy. 2011 Jan-Feb;10(1):29-34. PubMed PMID: 21251622.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - One-step customized transurethral resection of the prostate and permanent implant brachytherapy for selected prostate cancer patients: technically feasible but too toxic. AU - Cosset,Jean-Marc, AU - Barret,Eric, AU - Castro-Pena,Pablo, AU - Cathelineau,Xavier, AU - Galiano,Marc, AU - Rozet,François, AU - Pierrat,Noëlle, AU - Timbert,Michel, AU - Vallancien,Guy, PY - 2011/1/22/entrez PY - 2011/1/22/pubmed PY - 2011/4/27/medline SP - 29 EP - 34 JF - Brachytherapy JO - Brachytherapy VL - 10 IS - 1 N2 - INTRODUCTION: Patients with prominent median lobe hyperplasia and/or high International Prostate Symptom Score (IPSS) are often contraindicated for prostate brachytherapy, mainly because of the risk of post-implant urinary retention. We evaluated an approach combining in the same operative step a limited transurethral resection (TURP) of the median lobe, immediately followed by permanent implant-free seed brachytherapy. METHODS AND MATERIALS: From January 2007 to November 2008, 22 patients underwent a customized limited TURP of their median lobe immediately before brachytherapy. All patients fulfilled our criteria for permanent implant brachytherapy, but presented with a more or less prominent median lobe and/or a high IPSS. RESULTS: The procedure appeared to be technically feasible, with only 0.3% of migrating seeds, a mean post-implant D90 of 173.4 Gy and a mean post-implant V100 of 96.6%. However, 5 patients (23%) experienced a urinary retention, with two patients having to undergo a complementary post-implant TURP. Moreover, urinary toxicity was more pronounced than in our current experience, with high IPSS at 2 months (mean 19.2) and 6 months (mean 15.8). CONCLUSION: Although technically feasible, with relatively few migrating seeds and satisfactory post-implant dosimetric parameters, one-step TURP and brachytherapy was found to be poorly tolerated, with higher than usual urinary retention and urinary toxicity rates. Considering those results, our group is presently evaluating a two-step procedure, with a customized TURP followed after 4-6 months by brachytherapy. SN - 1873-1449 UR - https://www.unboundmedicine.com/medline/citation/21251622/One_step_customized_transurethral_resection_of_the_prostate_and_permanent_implant_brachytherapy_for_selected_prostate_cancer_patients:_technically_feasible_but_too_toxic_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1538-4721(10)00352-1 DB - PRIME DP - Unbound Medicine ER -