Influence of prophylactic dexamethasone on edema following prostate brachytherapy.
OBJECTIVE
This work evaluates the prophylactic administration of dexamethasone as an adjunct to prostate brachytherapy to determine the effect of dexamethasone on postimplant edema, dosimetric quality, catheter dependency, and clinical outcome as assessed by serial American Urological Association (AUA) symptom score determinations.


METHODS
In a controlled study, 22 unselected patients were placed alternately into either a dexamethasone or control arm.


RESULTS
There was no statistically significant difference in volume between the experimental and control groups on either day 0 or day 28. Accordingly, the day 0 dosimetric parameters, short-term catheter dependency, and serial AUA symptom score determinations were equivalent in both patient groups. However, the patients receiving dexamethasone had a markedly smaller volume on day 3, but 9 of 11 experienced rebound edema with a volume on day 14 significantly greater than day 3.


CONCLUSIONS
Because of the small number of patients evaluated, additional studies are essential to confirm these findings. At the present time, we do not recommend this dexamethasone schedule as a routine component of prostate brachytherapy.
Merrick
G S
GS
Schiffler Oncology Center, Wheeling Hospital, West Virginia 26003-6300, USA.
Butler
W M
WM
Dorsey
A T
AT
Lief
J H
JH
Totterd
Coram
R J
RJ
D001918:Brachytherapy / Q000009:adverse effects*; D003907:Dexamethasone / Q000627:therapeutic use*; D004487:Edema / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects; D008297:Male; D010165:Palladium / Q000009:adverse effects; D010502:Perineum / Q000000981:diagnostic imaging; D011467:Prostate / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000528:radiation effects; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D011868:Radioisotopes / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography
D005938:Glucocorticoids; D007457:Iodine Radioisotopes; D011868:Radioisotopes; D010165:Palladium; D003907:Dexamethasone