EFFECTS OF BRACHYTHERAPY BOOST ON PROSTATE CANCER TREATED WITH EXTERNAL BEAM RADIOTHERAPY: A PILOT STUDY
2 NSIA – LUTH Cancer Centre, Lagos state.
3 Department of Radiation Oncology, Obafemi Awolowo University Teaching Hospital, Ile-Ife.
4 Radiation Oncology Department, University College Hospital, Ibadan, Oyo State, Nigeria
* Corresponding author: mailolabissy@yahoo.com
Abstract
Background: Prostate cancer is the leading cause of cancer amongst men in Nigeria. External beam radiotherapy (EBRT) and high-dose rate brachytherapy (HDR-BT) play a significant role in the management of localised prostate cancer.
Objective: This study compared the treatment outcome of the management of intermediate and high-risk localised prostate cancer patients using EBRT alone and EBRT + BT.
Methods: A pilot study was conducted at the University College Hospital, Ibadan, and the Lagos University Teaching Hospital. Thirty-eight (38) patients were recruited, with 19 patients in both EBRT alone and EBRT+BT arms. Biochemical-free survival (BFS), late side effects, and quality of life (QoL) were assessed and compared across both arms. Biochemical free survival was calculated using the Kaplan-Meier survival curve and compared using log log-rank test, quality of life was assessed using the EORTC quality of life questionnaire and mean compared using the t-test. Late side effects were assessed using the RTOG questionnaire and compared using chi-square. Ethical approval was obtained from both institutions.
Results: Twenty-seven percent (23%) of the patients recruited had intermediate-risk disease, while seventy-three percent (73%) had high-risk disease, with ADT used before radiotherapy in 71.1%. The mean EQD2 in the EBRT arm and EBRT+BT arm was 63.0Gy and 81.5Gy, respectively. BFS at 12 months was 81.8% and 88.2% for EBRT and EBRT+BT, respectively. Mean time to biochemical recurrence was 11.46 months and 11.82 months for EBRT and EBRT+BT, respectively (p=0.625). All biochemical failures occurred among the high-risk group, with BFS at 12 months being 71.4% and 84.6% for EBRT and EBRT+BT, respectively (p=0.468). Grade 1 and 2 late Genitourinary toxicities were more in the EBRT arm (10.5% and 52.6% respectively) compared to the EBRT+BT arm (5.3% and 15.8% respectively) (P=0.03). Comparison of Gastrointestinal late toxicities, QoL, and sexual function in both arms was not statistically significant.
Conclusion: BFS was similar in both treatment arms; however, the EBRT+BT arm had fewer genitourinary side effects than the EBRT arm. Gastrointestinal toxicities, QoL, and sexual dysfunction had comparative incidence in both arms.
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