Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jan 11;18(1):128.
doi: 10.3390/ijms18010128.

Perioperative Search for Circulating Tumor Cells in Patients Undergoing Prostate Brachytherapy for Clinically Nonmetastatic Prostate Cancer

Hideyasu Tsumura  1 , Takefumi Satoh  2 , Hiromichi Ishiyama  3 , Ken-Ichi Tabata  4 , Kouji Takenaka  5 , Akane Sekiguchi  6 , Masaki Nakamura  7 , Masashi Kitano  8 , Kazushige Hayakawa  9 , Masatsugu Iwamura  10
Affiliations

Perioperative Search for Circulating Tumor Cells in Patients Undergoing Prostate Brachytherapy for Clinically Nonmetastatic Prostate Cancer

Hideyasu Tsumura et al. Int J Mol Sci. .

Abstract

Despite the absence of local prostate cancer recurrence, some patients develop distant metastases after prostate brachytherapy. We evaluate whether prostate brachytherapy procedures have a potential risk for hematogenous spillage of prostate cancer cells. Fifty-nine patients who were undergoing high-dose-rate (HDR) or low-dose-rate (LDR) brachytherapy participated in this prospective study. Thirty patients with high-risk or locally advanced cancer were treated with HDR brachytherapy after neoadjuvant androgen deprivation therapy (ADT). Twenty-nine patients with clinically localized cancer were treated with LDR brachytherapy without neoadjuvant ADT. Samples of peripheral blood were drawn in the operating room before insertion of needles (preoperative) and again immediately after the surgical manipulation (intraoperative). Blood samples of 7.5 mL were analyzed for circulating tumor cells (CTCs) using the CellSearch System. While no preoperative samples showed CTCs (0%), they were detected in intraoperative samples in 7 of the 59 patients (11.8%; preoperative vs. intraoperative, p = 0.012). Positive CTC status did not correlate with perioperative variables, including prostate-specific antigen (PSA) at diagnosis, use of neoadjuvant ADT, type of brachytherapy, Gleason score, and biopsy positive core rate. We detected CTCs from samples immediately after the surgical manipulation. Further study is needed to evaluate whether those CTCs actually can survive and proliferate at distant sites.

Keywords: brachytherapy; circulating tumor cell; prostate cancer.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Comparison of circulating tumor cell (CTC) detection rates between pre- and intraoperative blood specimens in all patients undergoing high-dose-rate or low-dose-rate brachytherapy (n = 59).
Figure 2
Figure 2
Comparison of circulating tumor cell (CTC) detection rates between pre- and intraoperative blood specimens in patients undergoing high-dose-rate (A, n = 30) and low-dose-rate (B, n = 29) brachytherapy.
See this image and copyright information in PMC

References

    1. Zelefsky M.J., Kuban D.A., Levy L.B., Potters L., Beyer D.C., Blasko J.C., Moran B.J., Ciezki J.P., Zietman A.L., Pisansky T.M., et al. Multi-institutional analysis of long-term outcome for stages T1-T2 prostate cancer treated with permanent seed implantation. Int. J. Radiat. Oncol. Biol. Phys. 2007;67:327–333. doi: 10.1016/j.ijrobp.2006.08.056. - DOI - PubMed
    1. Stone N.N., Stock R.G., Cesaretti J.A., Unger P. Local control following permanent prostate brachytherapy: Effect of high biologically effective dose on biopsy results and oncologic outcomes. Int. J. Radiat. Oncol. Biol. Phys. 2010;76:355–360. doi: 10.1016/j.ijrobp.2009.01.078. - DOI - PubMed
    1. Hoskin P.J., Rojas A.M., Bownes P.J., Lowe G.J., Ostler P.J., Bryant L. Randomised trial of external beam radiotherapy alone or combined with high-dose-rate brachytherapy boost for localised prostate cancer. Radiother. Oncol. 2012;103:217–222. doi: 10.1016/j.radonc.2012.01.007. - DOI - PubMed
    1. Prada P.J., Gonzalez H., Fernandez J., Jimenez I., Iglesias A., Romo I. Biochemical outcome after high-dose-rate intensity modulated brachytherapy with external beam radiotherapy: 12 Years of experience. BJU Int. 2012;109:1787–1793. doi: 10.1111/j.1464-410X.2011.10632.x. - DOI - PubMed
    1. Ishiyama H., Satoh T., Kitano M., Tabata K., Komori S., Ikeda M., Soda I., Kurosaka S., Sekiguchi A., Kimura M., et al. High-dose-rate brachytherapy and hypofractionated external beam radiotherapy combined with long-term hormonal therapy for high-risk and very high-risk prostate cancer: Outcomes after 5-year follow-up. J. Radiat. Res. 2014;55:509–517. doi: 10.1093/jrr/rrt128. - DOI - PMC - PubMed