PURPOSE: To develop a consensus guideline between the American Brachytherapy Society (ABS) and Groupe Européen de Curiethérapie/European Society for Therapeutic Radiation and Oncology (GEC-ESTRO) for the use of brachytherapy in the primary management of carcinoma of the penis.
METHODS AND MATERIALS: The American Brachytherapy Society and Groupe Européen de Curiethérapie/European Society for Therapeutic Radiation and Oncology convened a group of expert practitioners and physicists to develop guidelines for the use of 192Ir in low-dose-rate (LDR), pulse-dose-rate, and high-dose-rate (HDR) brachytherapy for penile cancer.
RESULTS: Decades of brachytherapy experience with LDR 192Ir wire and pulse-dose-rate 192Ir sources for this rare malignancy indicate a penile preservation rate of 70% at 10 years postimplant. Chief morbidities remain stenosis of the urethral meatus and soft tissue ulceration at the primary site. Nonhealing ulceration can be successfully managed with various measures including hyperbaric oxygen treatment. HDR brachytherapy implant procedures are technically similar to LDR. The optimal HDR dose and fractionation schemes are being developed.
CONCLUSIONS: The good tumor control rates, acceptable morbidity, and functional organ preservation warrant recommendation of brachytherapy as the initial treatment for invasive T1, T2, and selected T3 penile cancers.
Written by:
Crook JM, Haie-Meder C, Demanes DJ, Mazeron JJ, Martinez AA, Rivard MJ. Are you the author?
Department of Radiation Oncology, British Columbia Cancer Agency, Center for the Southern Interior, Kelowna, BC, Canada.
Reference: Brachytherapy. 2013 Feb 28. pii: S1538-4721(13)00204-3.
doi: 10.1016/j.brachy.2013.01.167
PubMed Abstract
PMID: 23453681
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