Single-fraction high-dose-rate brachytherapy: a scoping review on outcomes and toxicities for all disease sites.

IF 1.1 4区 医学 Q4 ONCOLOGY Journal of Contemporary Brachytherapy Pub Date : 2022-10-01 DOI:10.5114/jcb.2022.121477
Mehdi Kazemi, Sarah Nadarajan, Mitchell Kamrava
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引用次数: 1

Abstract

Purpose: Brachytherapy is well positioned to safely deliver highly conformal single-fraction doses of radiation, which can lower costs and improve efficiency. Traditionally, high-dose-rate brachytherapy (HDR-BT) has been delivered over multiple treatments. A scoping literature review was conducted to better understand the available literature on single-fraction HDR-BT for all disease sites.

Material and methods: According to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, PubMed database was queried from 1994-2021 using the following search terms: 'brachytherapy', 'high-dose-rate', and 'single-fraction'. A total of 53 studies met our exclusion criteria.

Results: Liver had the highest number of studies, with a total of 618 patients treated with doses ranging from 8 to 25 Gy. Median follow-up ranged from 11-33 months. Local control (LC) rates ranged from 37% to 98%. G3 acute/late toxicities or higher were reported in 3 patients. Prostate cancer included a total of 1,474 patients treated with doses ranging from 19 to 21 Gy. Median follow-up ranged from 20 to 72 months. Prostate specific antigen (PSA) control outcomes after definitive treatment ranged from 65% to 94%, and salvage treatments from 5% to 84%. G3 acute/late toxicities or higher ranged from 0 to 6%. Breast cancer included a total of 268 patients treated with doses ranging from 16 to 20 Gy. Median follow-up ranged from 24 to 72 months. LC rates were 100%. G3 acute toxicities or higher ranged from 0 to 6%. Regarding other cancers, conclusions were limited given the small number of patients within each respective site.

Conclusions: Currently used regimens appear safe, but efficacy vary by different disease sites. Outcomes are more promising for breast and liver, while are less encouraging for prostate. Additional prospective evaluation of single-fraction HDR-BT regimens are warranted.

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单次高剂量率近距离放射治疗:对所有疾病部位的结果和毒性的范围综述
目的:近距离放射治疗是一种安全、高适形的单组分放射治疗,可以降低成本,提高效率。传统上,高剂量率近距离放射治疗(HDR-BT)是在多次治疗中进行的。为了更好地了解所有疾病部位单组分HDR-BT的现有文献,进行了范围文献综述。材料和方法:根据系统评价和荟萃分析(PRISMA)指南的首选报告项目,使用以下搜索词查询PubMed数据库1994-2021年的数据:“近距离治疗”、“高剂量率”和“单组分”。共有53项研究符合我们的排除标准。结果:肝脏的研究数量最多,共618例患者,剂量范围为8 - 25 Gy。中位随访时间为11-33个月。局部控制率从37%到98%不等。3例患者报告G3急性/晚期或以上毒性。前列腺癌共包括1,474名接受19至21戈瑞剂量治疗的患者。中位随访时间为20至72个月。明确治疗后的前列腺特异性抗原(PSA)控制结果从65%到94%不等,挽救治疗后的结果从5%到84%不等。G3急性/晚期或更高的毒性范围为0 - 6%。乳腺癌共包括268名接受16至20戈瑞剂量治疗的患者。中位随访时间为24至72个月。信用证利率为100%。G3急性毒性或更高的毒性范围为0 - 6%。至于其他癌症,由于每个部位的患者数量较少,因此结论有限。结论:目前使用的方案似乎是安全的,但疗效因不同的疾病部位而异。乳房和肝脏的治疗结果更有希望,而前列腺则不那么令人鼓舞。需要对单组分HDR-BT方案进行额外的前瞻性评估。
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来源期刊
Journal of Contemporary Brachytherapy
Journal of Contemporary Brachytherapy ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
2.40
自引率
14.30%
发文量
54
审稿时长
16 weeks
期刊介绍: The “Journal of Contemporary Brachytherapy” is an international and multidisciplinary journal that will publish papers of original research as well as reviews of articles. Main subjects of the journal include: clinical brachytherapy, combined modality treatment, advances in radiobiology, hyperthermia and tumour biology, as well as physical aspects relevant to brachytherapy, particularly in the field of imaging, dosimetry and radiation therapy planning. Original contributions will include experimental studies of combined modality treatment, tumor sensitization and normal tissue protection, molecular radiation biology, and clinical investigations of cancer treatment in brachytherapy. Another field of interest will be the educational part of the journal.
期刊最新文献
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