low dose rate prostate brachytherapy l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Low dose-rate prostate brachytherapy PowerPoint Presentation
Download Presentation
Low dose-rate prostate brachytherapy

Loading in 2 Seconds...

play fullscreen
1 / 20

Low dose-rate prostate brachytherapy - PowerPoint PPT Presentation


  • 569 Views
  • Uploaded on

Low dose-rate prostate brachytherapy. Self-learning tutorial. What is it? A self-learning slide tutorial, including detailed slide notes , to work through at your own pace Part of the Prostate Brachytherapy Advisory Group (PBAG) online nurse education programme Why is it being provided?

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Low dose-rate prostate brachytherapy' - devon


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
about this slide tutorial

What is it?

  • A self-learning slide tutorial, including detailed slide notes, to work through at your own pace
  • Part of the Prostate Brachytherapy Advisory Group (PBAG) online nurse education programme

Why is it being provided?

  • To help you understand more about prostate brachytherapy, an increasingly popular alternative to prostatectomy and external beam radiotherapy (EBRT), for patients with localised prostate cancer
About this slide tutorial
about this slide tutorial3

To view the detailed notes, select either ‘View Normal’ or ‘View Notes Pages’

  • To view slides on full screen (no notes visible) select ‘View Slide Show’
  • To print the notes and the slides, select ‘Print notes pages’
About this slide tutorial
nice prostate cancer guideline

2008 NICE guideline on prostate cancer identified prostate brachytherapy, along with prostatectomy and EBRT, as one of the three proven radical treatment options for men with low- or intermediate-risk localised prostate cancer

NICE prostate cancer guideline

2008 NICE guideline on the diagnosis and treatment of prostate cancer

what is prostate brachytherapy 1

Prostate brachytherapy involves the transperineal placement of radioactive seeds directly into the prostate

  • This treatment delivers a high dose of radiation directly into the prostate
  • During the procedure, rectal ultrasound is used to assess the size and shape of the prostate
What is prostate brachytherapy? (1)
what is prostate brachytherapy 2

The seeds are placed into the prostate through fine hollow needles inserted into the perineum

  • A grid-like device is used to guide the needles into the correct position
  • A computer program ensures that the right dose of radiation is delivered to the prostate and that other organs are unaffected
  • The seeds stay in the prostate permanently and remain radioactive for 3-9 months
What is prostate brachytherapy? (2)
which patients are candidates for brachytherapy

Treatment selector chart from the

Prostate Cancer Centre, Guildford

  • Many patients with localised prostate cancer are potential candidates for prostate brachytherapy
  • Patient characteristics including cancer risk, age and prostate size, help to determine which treatment is most appropriate
Which patients are candidatesfor brachytherapy?
what are the side effects

Prostate brachytherapy is associated with fewer complications and side-effects than other radical treatments

Treatment selector chart from the Prostate Cancer Centre, Guildford

What are the side-effects?
clinical efficacy of prostate brachytherapy 1

Numerous clinical studies have shown that prostate brachytherapy is highly effective at curing cancer and prolonging survival in patients with localised prostate cancer

Clinical efficacy of prostate brachytherapy (1)
clinical efficacy of prostate brachytherapy 2

Prostate brachytherapy, prostatectomy and EBRT are equally effective at curing cancer and prolonging survival in patients with localised prostate cancer

Clinical efficacy of prostate brachytherapy (2)

1

0.8

EB≥72Gy

COMB

PI

0.6

bRFS

RP

0.4

RP = radical prostatectomyEBRT = external beam radiotherapyPI = permanent seed implantation(LDR brachytherapy)COMB = combined seeds and EBRT

0.2

p=0.18

0

36

84

0

12

24

48

60

72

Months

Kupelian et al. Int J Radiat Oncol Biol Phys 2004

quality of life following prostate brachytherapy

Prostate brachytherapy, prostatectomy and EBRT have different effects on patients’ quality of life

    • Treatment decisions should take into account the effects of treatment on quality of life, as well as survival

EPIC: Urinary Function

EPIC: Urinary Bother

Quality of life following prostate brachytherapy

100

100

90

90

80

80

70

70

60

60

50

50

40

40

30

30

20

20

10

10

0

0

Pre-treatment

Month 1*†

Month 3*†

Month 6*†‡

Month 12*†

Month 24*†

Pre-treatment

Month 1*

Month 3*‡

Month 6*‡

Month 12

Month 24

EPIC: Sexual Bother

EPIC: Sexual Function

100

100

90

90

80

80

70

70

60

60

50

50

40

40

30

30

20

20

10

10

0

0

Pre-treatment*†

Month 1*†

Month 3*†

Month 6*†

Month 12†‡

Month 24†‡

Pre-treatment

Month 1*†

Month 3*†

Month 6*†

Month 12*†

Month 24*†

Radical prostatectomy

Brachytherapy

Three-dimensional (3D) external beam radiotherapy

Adapted from Ferrer et al.

Int J Radiat Oncol Biol Phys 2008 (Fig 4)

Higher score = better function

Ferrer M et al. Int J Radiat Oncol Biol Phys 2008; 72: 421–32.

advantages and disadvantages of prostate brachytherapy
Advantages

Disadvantages

Patients can experience transient urinary irritative symptoms

Close contact with small children and pregnant women should be avoided in first 2 months after treatment

  • Avoids physical trauma of a major surgical procedure
  • One-off minimally invasive procedure requiring minimal hospitalilsation
  • Procedure causes minimal bleeding
  • Precise placement of the seeds offers more tailored treatment
  • Relatively few long-term side-effects
  • Quick recovery and return to normal activity
  • More likely to retain quality of life compared with other treatments
  • Maintains sexual potency in many patients
  • Produces good long-term clinical outcomes
  • Cost-effective treatment option
Advantages and disadvantages of prostate brachytherapy
how does prostate brachytherapy compare with other radical treatments

Efficacy

    • Equivalent efficacy to prostatectomy and EBRT
  • Quality of life
    • Quality of life is more likely to be retained than after prostatectomy or EBRT
    • Side effects are generally not as serious; sexual side-effects are less common than after prostatectomy
  • Hospital stay
    • Prostate brachytherapy: 1 or 2 day visits
    • EBRT: many day visits(5 days-a-week for 4–7 weeks)
    • Prostatectomy: prolonged hospital stay (up to 1 week)
How does prostate brachytherapy compare with other radical treatments?
questions your patients may ask 1

If I have prostate brachytherapy do I become radioactive?

Is prostate brachytherapy a new procedure?

Questions your patients may ask (1)

What about my sex-life after prostate brachytherapy?

questions your patients may ask 2

Where can I getprostate brachytherapy?

How long will it take toreturn to my normaldaily activities?

Questions your patients may ask (2)

Will the NHS pay

for my treatment?

summary prostate brachytherapy

An increasingly popular alternative to other recommended radical treatments for localised prostate cancer

  • Involves the transperineal placement of radioactive seeds directly into the prostate
  • As effective as other recommended radical treatments at curing cancer and prolonging patient survival
  • More likely to retain quality of life than other radical treatments
Summary: prostate brachytherapy
uk brachytherapy centres

The number of NHS and private hospitals and centres in the UK currently providing LDR prostate brachytherapy are:

England: 29

Scotland: 2 (Glasgow and Edinburgh)

Wales: 1 (Cardiff)

Ireland 2 (Dublin and Galway)

For a detailed list, download the separate file entitled ‘LDR brachytherapy centres’ available from the website of the Prostate Brachytherapy Advisory Group:

www.prostatebrachytherapyinfo.net

(See section: Information for healthcare professionals)

The website also contains additional detailed information about each centre in the section ‘UK brachytherapy centres’.

UK brachytherapy centres
further information

NICE

  • Prostate cancer: diagnosis and treatment clinical guideline CG58
  • nice.org.uk/guidance/CG58
    • For patients
      • Understanding NICE guidance
    • For healthcare professionals
      • The guideline in full
      • Implementation advice
      • Slide set

Prostate brachytherapy

  • See the following websites for further information:
  • prostatebrachytherapyinfo.net
  • prostatebrachytherapycentre.com
Further information
the prostate brachytherapy advisory group pbag

Stephen Langley (Chair)

    • Professor of Urology, Prostate Brachytherapy Centre, Guildford
  • Niki Baier
    • NHS Commissioning Advisor, Surrey
  • David Bottomley
    • Consultant Clinical Oncologist, St James’s Institute of Oncology, Leeds
  • Richard Gledhill
    • Prostate Cancer Charity Specialist Nurse, Queen Elizabeth Hospital, Birmingham
  • Philip Marazzi
    • General Practitioner, East Horsley, Surrey
  • Rick Popert
    • Consultant Urological Surgeon, Guy’s and St Thomas’ NHS Foundation Trust, London
  • Graham Robson
    • Patient Representative, Aberdeen
The Prostate Brachytherapy Advisory Group (PBAG)

Learn more about PBAG at: www.prostatebrachytherapyinfo.net

Email the PBAG at: admin@prostatebrachytherapyinfo.net

The activities of the PBAG are supported by an

unrestricted educational grant from Oncura