Dataset Information

Tri-modality therapy with i-125 brachytherapy, external beam radiation therapy, and short-term hormone therapy for high-risk prostate cancer after holmium laser enucleation of the prostate.

ABSTRACT:

Introduction

We present tri-modality therapy with i-125 brachytherapy for high-risk prostate cancer after holmium laser enucleation of the prostate.

Case presentation

A 75-year-old man had visited our hospital with complaints of dysuria. Holmium laser enucleation of the prostate was performed for benign prostatic hyperplasia. The resected histopathological prostate tissue showed malignancy (Gleason score: 3 + 3 = 6). Two years thereafter, Gleason score progressed (4 + 5 = 9) concomitantly with increased prostate-specific antigen levels. Therefore, tri-modality therapy, including brachytherapy, was applied. Combined androgen blockade therapy was conducted over a 9-month period. One month after brachytherapy, external beam radiation was performed.

Conclusion

Brachytherapy following transurethral prostate surgery is relatively contraindicated because of increased adverse urethral event frequency and seed placement difficulties. A tri-modality therapy, including brachytherapy, was implemented without any major problems in this patient with high-risk prostate cancer after holmium laser enucleation of the prostate, following which he had a favorable prognosis without recurrence for 6 years.

SUBMITTER: Nakiri M

PROVIDER: S-EPMC9249659 | biostudies-literature | 2022 Jul

REPOSITORIES: biostudies-literature

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Publications

Tri-modality therapy with i-125 brachytherapy, external beam radiation therapy, and short-term hormone therapy for high-risk prostate cancer after holmium laser enucleation of the prostate.

Nakiri Makoto M Ueda Kosuke K Ogasawara Naoyuki N Kurose Hirofumi H Uemura Keiichiro K Nishihara Kiyoaki K Muraki Koichiro K Hattori Chikayuki C Ogo Etsuyo E Igawa Tsukasa T

IJU case reports 20220330 4

<h4>Introduction</h4>We present tri-modality therapy with i-125 brachytherapy for high-risk prostate cancer after holmium laser enucleation of the prostate.<h4>Case presentation</h4>A 75-year-old man had visited our hospital with complaints of dysuria. Holmium laser enucleation of the prostate was performed for benign prostatic hyperplasia. The resected histopathological prostate tissue showed malignancy (Gleason score: 3 + 3 = 6). Two years thereafter, Gleason score progressed (4 + 5 = 9) conco ...[more]

PMID: 35795117

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Project description:PurposeTo compare patient-reported disease-specific functional outcomes after external beam radiation therapy (EBRT) and EBRT combined with low-dose-rate brachytherapy prostate boost (EB-LDR) among men with localized prostate cancer.Methods and materialsThe prospective, population-based Comparative Effectiveness Analysis of Surgery and Radiation study enrolled men with localized prostate cancer in 2011 to 2012. The 26-item Expanded Prostate Cancer Index Composite measured patient-reported disease-specific function at baseline and at 6, 12, and 36 months. Higher domain scores indicate better function. Minimal clinically important difference was defined as 6 for urinary incontinence, 5 for urinary irritative function, 4 for bowel function, 12 for sexual function, and 4 for hormonal function. Multivariable linear and logistic regression models were fit to estimate the effect of treatment on patient-reported outcomes.ResultsFive-hundred seventy-eight men received EBRT and 109 received EB-LDR. Median patient age was 69 years, and 70% had intermediate- or high-risk disease. Men in the EB-LDR group were younger (P < .001) and less likely to receive androgen deprivation therapy (P < .001). Baseline urinary, bowel, sexual, and hormonal function was similar between treatment groups (P > .05). On multivariable analyses, men receiving EB-LDR reported worse urinary irritative function at 6 months (adjusted mean difference [AMD] -14.4, P < .001), 12 months (AMD -12.9, P < .001), and 36 months (AMD -4.7, P = .034) than men receiving EBRT. At 12 months, men receiving EB-LDR reported worse bowel function (AMD -5.8, P = .002), but these differences were not seen at 36 months. There were no significant differences in sexual or hormone function between treatment groups.ConclusionsMen treated with EB-LDR report worse bowel function at 1 year and worse urinary irritative function through 3 years compared with men treated with EBRT alone. These side effect profiles should be discussed with patients when considering EB-LDR versus EBRT treatment.

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Dataset Information

Tri-modality therapy with i-125 brachytherapy, external beam radiation therapy, and short-term hormone therapy for high-risk prostate cancer after holmium laser enucleation of the prostate.

Introduction

Case presentation

Conclusion

Publications

Tri-modality therapy with i-125 brachytherapy, external beam radiation therapy, and short-term hormone therapy for high-risk prostate cancer after holmium laser enucleation of the prostate.

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