A phase II study of external beam radiotherapy combined with permanent source brachytherapy for intermediate-risk, clinically localized adenocarcinoma of the prostate: preliminary results of RTOG P-0019.
OBJECTIVE
To estimate the rate of acute and late Grade 3-5 genitourinary and gastrointestinal toxicity after treatment with external beam radiotherapy and permanent source brachytherapy in a multi-institutional, cooperative group setting.


METHODS
All patients were treated with external beam radiotherapy (45 Gy in 25 fractions), followed 2-6 weeks later by an interstitial implant using 125I to deliver an additional 108 Gy. Late genitourinary toxicity was graded according to the Common Toxicity Criteria Version 2.0, and the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer late radiation morbidity scoring system was used for all other toxicity.


RESULTS
A total of 138 patients from 28 institutions were entered on this study. Acute toxicity information was available in 131 patients, and 127 patients were analyzable for late toxicity. Acute Grade 3 toxicity was documented in 10 of 131 patients (7.6%). No Grade 4 or 5 acute toxicity has been observed. The 18-month month estimate of late Grade 3 genitourinary and gastrointestinal toxicity was 3.3% (95% confidence interval, 0.1-6.5). No late Grade 4 or 5 toxicity has been observed.


CONCLUSIONS
The acute and late morbidity observed in this multi-institutional, cooperative group study is consistent with previous reports from single institutions with significant prostate brachytherapy experience.
Lee
W Robert
WR
Department of Radiation Oncology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1030, USA. wrlee@wfubmc.edu
DeSilvio
Michelle
M
Lawton
Colleen
C
Gillin
Michael
M
Morton
Gerard
G
Firat
Selim
S
Baikadi
Madhava
M
Kuettel
Michael
M
Greven
Kathryn
K
Sandler
Howard
H
D000230:Adenocarcinoma / Q000532:radiotherapy*; D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D007172:Erectile Dysfunction / Q000209:etiology; D041981:Gastrointestinal Tract / Q000528:radiation effects*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology*; D011878:Radiotherapy / Q000379:methods; D011879:Radiotherapy Dosage; D014566:Urogenital System / Q000528:radiation effects*
D007457:Iodine Radioisotopes