Definitive treatment for primary urethral cancer: A single institution's experience with organ-preserving brachytherapy.

Brachytherapy Dose-escalation Organ-preservation Primary urethral cancer

Journal

Brachytherapy
ISSN: 1873-1449
Titre abrégé: Brachytherapy
Pays: United States
ID NLM: 101137600

Informations de publication

Date de publication:
08 Oct 2024
Historique:
received: 16 07 2024
revised: 14 08 2024
accepted: 04 09 2024
medline: 10 10 2024
pubmed: 10 10 2024
entrez: 9 10 2024
Statut: aheadofprint

Résumé

Radical urethectomy ± cystectomy has long represented the standard of care for rare primary urethral cancer (PUC). With our analysis, we want to demonstrate the efficacy and safety of brachytherapy (BT) of urethra for organ preservation. We analyzed treatment procedures and results of 3 patients with PUC, which have been treated in our department between 2011 and 2020 with brachytherapy. One male patient underwent brachytherapy with chemoradiotherapy after transurethral resection (TUR). Brachytherapy has been performed as high-dose-rate (HDR) boost with a cumulative dose of 8 Gy (9.3 Gy Median follow-up was 103 months (41-153). No local recurrence occurred and all patients are still alive. For the male patient we documented Grade 3 cystitis. As late side effects the pre-existing Grade 2 incontinence worsened to Grade 3. Among female patients one developed Grade 3 vaginal synechiae. There was no Grade ≥4 toxicity. Brachytherapy in PUC is a feasible and promising option with high local control rate and tolerable toxicity. It provides a good alternative to surgery for organ preservation in selected patients.

Sections du résumé

BACKGROUND BACKGROUND
Radical urethectomy ± cystectomy has long represented the standard of care for rare primary urethral cancer (PUC). With our analysis, we want to demonstrate the efficacy and safety of brachytherapy (BT) of urethra for organ preservation.
MATERIALS AND METHODS METHODS
We analyzed treatment procedures and results of 3 patients with PUC, which have been treated in our department between 2011 and 2020 with brachytherapy. One male patient underwent brachytherapy with chemoradiotherapy after transurethral resection (TUR). Brachytherapy has been performed as high-dose-rate (HDR) boost with a cumulative dose of 8 Gy (9.3 Gy
RESULTS RESULTS
Median follow-up was 103 months (41-153). No local recurrence occurred and all patients are still alive. For the male patient we documented Grade 3 cystitis. As late side effects the pre-existing Grade 2 incontinence worsened to Grade 3. Among female patients one developed Grade 3 vaginal synechiae. There was no Grade ≥4 toxicity.
CONCLUSION CONCLUSIONS
Brachytherapy in PUC is a feasible and promising option with high local control rate and tolerable toxicity. It provides a good alternative to surgery for organ preservation in selected patients.

Identifiants

pubmed: 39384520
pii: S1538-4721(24)00394-5
doi: 10.1016/j.brachy.2024.09.001
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

Auteurs

R Merten (R)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; Bavarian Cancer Research Center (BZKF), Erlangen, Germany. Electronic address: ricarda.merten@uk-erlangen.de.

V Strnad (V)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; Bavarian Cancer Research Center (BZKF), Erlangen, Germany.

A Karius (A)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; Bavarian Cancer Research Center (BZKF), Erlangen, Germany.

M Lotter (M)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; Bavarian Cancer Research Center (BZKF), Erlangen, Germany.

S Kreppner (S)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; Bavarian Cancer Research Center (BZKF), Erlangen, Germany.

C Schweizer (C)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; Bavarian Cancer Research Center (BZKF), Erlangen, Germany.

R Fietkau (R)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; Bavarian Cancer Research Center (BZKF), Erlangen, Germany.

P Schubert (P)

Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; Comprehensive Cancer Center Alliance WERA (CCC WERA), Erlangen, Germany; Bavarian Cancer Research Center (BZKF), Erlangen, Germany.

Classifications MeSH