Oral and Poster Presentation – Clinical Abstracts Archive

UK & Ireland Prostate Brachytherapy Conference 2017

Abstract number 3

Short-term clinical toxicity of HDR Brachytherapy in prostate cancer patients with infl ammatory bowel disease

Mohammed W*; Henry A**; Gomez-Iturriaga A†; Hoskin P††; Roberts C††; Nikapota A*
*The Royal Sussex County Hospital, Brighton; **Leeds Teaching Hospital †Cruces University Hospital, Baracaldo, Spain; ††Mount Vernon Cancer Centre, Middlesex

AIMS/INTRODUCTION: The Royal Sussex County Hospital (Brighton UK) abstract : Introduction: Infl ammatory bowel disease (IBD) has historically been considered a risk factor for increased bowel toxicity in patients receiving pelvic external beam radiotherapy (EBRT). The risk is reduced in IMRT, compared to 3D-CRT. The effect of brachytherapy (BT) has been less extensively researched. Despite the increased dose to GTV and decreased dose to organs at risk (OAR), previous studies have recommended avoidance of low dose rate (LDR) brachytherapy in patients with IBD, due to increased bowel toxicity. We investigated the effect of high dose rate (HDR) brachytherapy in IBD.

MATERIALS/METHODS: 11 IBD patients across 4 different sites (in the UK and Spain) who received HDR brachytherapy, between 2012 and 2015, were followed up for up to 12 months. Acute bowel and urinary toxicity data was collected and recorded.

RESULTS: The median length of follow up was 6 months (range of 6 weeks to 12 months).
5 patients had Crohn’s Disease, and 6 patients had Ulcerative Colitis. Only 1 patient (Crohn’s Disease) had active disease at the time of treatment. This patient reported no bowel toxicity.
Of the remaining patients, 2 patients suffered Grade 1 diarrhoea (at 6 weeks, and 6 months).
3 patients suffered Grade 1 proctitis (at 6 weeks, and 6 months). There was no ≥ Grade 2 bowel toxicity. The most severe toxicity was Grade 2 urinary frequency in 1 patient (at 6 weeks).

CONCLUSION: This small, prospective case-series suggests that, in the short-term, HDR brachytherapy is safe and well tolerated in IBD patients. Therefore, IBD should not automatically disqualify patients from, at least, HDR brachytherapy. The reason why these results differ from previous LDR studies likely refl ects the benefit of inverse planning, which more readily achieves rectal dose constraints in HDR brachytherapy.