Urinary and Rectal Toxicity Profiles After Permanent Iodine-125 Implant Brachytherapy in Japanese Men: Nationwide J-POPS Multi-institutional Prospective Cohort Study

• Published in: International journal of radiation oncology, biology, physics Vol. 93; no. 1; pp. 141 - 149
• Main Authors: Ohashi, Toshio, Yorozu, Atsunori, Saito, Shiro, Tanaka, Nobumichi, Katayama, Norihisa, Kojima, Shinsuke, Maruo, Shinichiro, Kikuchi, Takashi, Dokiya, Takushi, Fukushima, Masanori, Yamanaka, Hidetoshi
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2015
• Subjects: Aged; Aged, 80 and over; BRACHYTHERAPY; Brachytherapy - adverse effects; Brachytherapy - methods; EXTERNAL BEAM RADIATION THERAPY; Hematology, Oncology and Palliative Medicine; Humans; IODINE 125; Iodine Radioisotopes - adverse effects; Iodine Radioisotopes - therapeutic use; Japan; Male; MEN; Middle Aged; NEOPLASMS; Organs at Risk - radiation effects; PATIENTS; Prospective Studies; PROSTATE; Prostate - radiation effects; Prostate-Specific Antigen - blood; Prostatic Neoplasms - blood; Prostatic Neoplasms - pathology; Prostatic Neoplasms - radiotherapy; Radiation Injuries - pathology; RADIATION SOURCE IMPLANTS; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; Radiotherapy Dosage; RECTUM; Rectum - radiation effects; RETENTION; SYMPTOMS; TOXICITY; Urethra - radiation effects; Japan
• ISSN: 0360-3016; 1879-355X; 1879-355X
• DOI: 10.1016/j.ijrobp.2015.05.014

To assess, in a nationwide multi-institutional cohort study begun in 2005 and in which 6927 subjects were enrolled by 2010, the urinary and rectal toxicity profiles of subjects who enrolled during the first 2 years, and evaluate the toxicity profiles for permanent seed implantation (PI) and a combination therapy with PI and external beam radiation therapy (EBRT). Baseline data for 2339 subjects out of 2354 patients were available for the analyses. Toxicities were evaluated using the National Cancer Institute's Common Terminology Criteria for Adverse Events, and the International Prostate Symptom Scores were recorded prospectively until 36 months after radiation therapy. Grade 2+ acute urinary toxicities developed in 7.36% (172 of 2337) and grade 2+ acute rectal toxicities developed in 1.03% (24 of 2336) of the patients. Grade 2+ late urinary and rectal toxicities developed in 5.75% (133 of 2312) and 1.86% (43 of 2312) of the patients, respectively. A higher incidence of grade 2+ acute urinary toxicity occurred in the PI group than in the EBRT group (8.49% vs 3.66%; P<.01). Acute rectal toxicity outcomes were similar between the treatment groups. The 3-year cumulative incidence rates for grade 2+ late urinary toxicities were 6.04% versus 4.82% for the PI and the EBRT groups, respectively, with no significant differences between the treatment groups. The 3-year cumulative incidence rates for grade 2+ late rectal toxicities were 0.90% versus 5.01% (P<.01) for the PI and the EBRT groups, respectively. The mean of the postimplant International Prostate Symptom Score peaked at 3 months, but it decreased to a range that was within 2 points of the baseline score, which was observed in 1625 subjects (69.47%) at the 1-year follow-up assessment. The acute urinary toxicities observed were acceptable given the frequency and retention, and the late rectal toxicities were more favorable than those of other studies.