| Abstract | PURPOSE: To evaluate rectal morbidity after dose escalation to biologic target volumes identified by capromab pendetide (ProstaScint) single-photon emission tomography images coregistered with computed tomography (SPECT/CT). METHODS AND MATERIALS: Two hundred thirty-nine consecutive patients diagnosed with T1c-T3b NxM0 adenocarcinoma of the prostate were treated with brachytherapy seed implant (SI) dose escalation to SPECT/CT-identified biologic target volumes, from February 1997 through December 2002. Patients received SI (n=150) or external beam radiation therapy plus SI (n=89). Rectal morbidity was evaluated by clinician scoring using the modified Radiation Therapy Oncology Group criteria. The median followup was 47.2 (range 24.8-96.1) months. RESULTS: The rate of acute Grades I and II toxicity was 29.9% and 3.7%, respectively, and chronic Grade I toxicity was 15.4%, 12.4%, 2.3%, and 1.8% at 1, 2, 3, and 4 years postimplant, respectively. Chronic Grade II toxicities were 1.8%, 1.9%, 1.5%, and 0.9% at 1, 2, 3, and 4 years, respectively. No Grade III rectal toxicity was reported. Chronic Grade IV rectal toxicity was 0.5% and 0.6% at 1.5 and 2.5 years, respectively. Ninety-six percent of patients reported freedom from all rectal toxicity after 3 years. CONCLUSIONS: Dose intensification to occult tumor targets without increasing rectal toxicity may be achieved using SPECT/CT ProstaScint. Additional research to define the role of molecular imaging in prostate cancer is warranted. |
| Authors | Rodney J Ellis, Hang Zhou, Deborah A Kaminsky, Pingfu Fu, Edward Y Kim, D Bruce Sodee, Valdir Colussi, John P Spirnak, Christopher C Whalen, Martin I Resnick
(Affiliation: Department of Radiation Oncology, Aultman Hospital, Canton, OH, USA. rellis at aultman.com)
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| Journal | Brachytherapy
(Brachytherapy)
2007 Apr-Jun
Vol. 6
Issue 2
Pg. 149-56
ISSN: 1538-4721 United States |
| PMID | 17434109
(Publication Type: Journal Article)
|
| Chemical References |
- Iodine Radioisotopes
- Palladium
|
| Topics |
- Adenocarcinoma
(pathology, radiotherapy)
- Adult
- Aged
- Aged, 80 and over
- Analysis of Variance
- Brachytherapy
(adverse effects, methods)
- Follow-Up Studies
- Gastrointestinal Motility
(radiation effects)
- Humans
- Iodine Radioisotopes
(adverse effects)
- Logistic Models
- Male
- Middle Aged
- Neoplasm Staging
- Palladium
(adverse effects)
- Prospective Studies
- Prostatic Neoplasms
(pathology, radiotherapy)
- Radiation Injuries
(diagnosis, etiology, physiopathology)
- Radiometry
- Radiotherapy Dosage
- Rectum
(physiopathology, radiation effects, radiography, radionuclide imaging)
- Tomography, Emission-Computed, Single-Photon
- Tomography, X-Ray Computed
- Treatment Outcome
- Tumor Burden
(radiation effects)
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