Purpose
Traditional methods of evaluating prostate cancer like rectal examination,
transrectal ultrasound,
sextant biopsies and prostate specific antigen (PSA) are able to predict indolent tumors and aggressive tumors.
However,
most patients are in an intermediate situation in which the accuracy of the above techniques is limited [1,
2].
Because of these limitations,
the accuracy of MRI in the study of local extension of prostatic cancer has been studied,
with encouraging results [3].
In the past decade,
the technology and prostate MRI has improved,
and also the...
Methods and Materials
The High Dose Rate Brachytherapy in real time program began at the Cruces University Hospital in 2011.
Patients:
The inclusion criteria for this radiotherapy treatment were: having an intermediate or high risk prostate carcinoma,
IPSS (International Prostate Symptom Score) under 15/35,
a prostate volume less than 60 cc,
and organ confined disease or extraglandular extension that can be covered securely with the HDR brachytherapy field.
Extension studies:
A PSA analytical cuantification,
prostate biopsy guided by transrectal ultrasound,
and extension studies with bone scintigraphy,
abdomen and...
Results
Results:
We have selected 50 consecutive patients with prostate cancer treatment,
candidates to combined HDR brachytherapy and EBRT.
All these patients underwent a pretreatment MRI for local staging.
The median age of patients was 71 years (range 58-78),
median pretreatment PSA 10.15 ng/ml (3.3-66),
the cores obtained median 10 (6-12) and a volume of 35 cc (14-58)
The clinicopathologic characteristics of the patients are presented in Table 1.
The parameters studied in MRI were agreed at uro-oncology tumors committee of our Hospital and were defined...
Conclusion
The MRI as a tool for prostate cancer staging results in a local disease overstaging,
with the resulting change in the patient risk group classification and in the administered treatment.
The MRI provides a very useful information for planning of HDR brachytherapy treatment.
References
1. Partin AW,
Kattan MW,
Subong EN,
et al.
Combination of prostate-specific antigen,
clinical stage,
and Gleason score to predict pathological stage of localized prostate cancer.
A multi-institutional update.
JAMA 1997;277:1445-51.
2. Partin AW,
Mangold LA,
Lamm DM,
Walsh PC,
Epstein JI,
Pearson JD.
Contemporary update of prostate cancer staging nomograms (Partin Tables) for the new millennium.
Urology 2001;58:843-8.
3. Huch Boni RA,
Boner JA,
Debatin JF,
et al.
Optimization of prostate carcinoma staging: comparison of imaging and clinical methods.
Clin Radiol 1995;50:593-600.
4. Giusti...