There are more clinical outcome studies with LDR, but HDR offers the potential see more for improved dosimetry as well as new and creative dose and fractionations that might improve
therapeutic ratios. Radiation safety is better with PDR and HDR remote afterloading. The advantages of BT are a more targeted dose distribution, the low integral dose, and shorter treatment times. Adjuvant BT monotherapy is appropriate for lesions of the trunk and extremity after complete surgical resection with negative margins. BT alone is also particularly helpful in pediatric and previously irradiated patients. Other cases, such as large, incompletely resected, or recurrent (not previously irradiated) lesions, may be best managed with a combination of BT and EBRT. “
“The Board of the American Brachytherapy Society (ABS) invited a leading author in the field (JMC) to draft a statement for penile brachytherapy with international participation. CH-M was invited to coauthor the statement. Subsequently, review and input were sought from those practitioners personally known to have experience in the field (AAM, DJD, and JJM). The final draft was approved by the ABS Board of Directors and by the Groupe Européen de Curiethérapie and the European Society of Therapeutic Radiation and Oncology Council.
Literature review revealed an absence of randomized studies. One multicenter retrospective review from Rozan et al. (1) in France and a handful of reported series from single www.selleckchem.com/products/ldk378.html institutions provide Level 3 evidence. Nonetheless we believe this consensus statement will provide valuable guidance. Squamous cell carcinoma of the penis is a relatively rare malignancy in the developed world, with an incidence of approximately 1 per 100,000 men (2), although much higher in some third world countries being more than 4 per 100,000 in Paraguay (3),
to and cited as up to 1% by age of 75 years in some parts of Uganda (4). It is highly curable in its early stages. Surgical amputation (penectomy) is often the first or only treatment method considered, but traditional amputative surgery is associated with a high level of psychosexual morbidity [5], [6] and [7]. Surgery, however, is not the only potentially curative treatment. Organ-sparing definitive radiation therapy, with or without local resection, can provide both cure and a high rate of penile preservation. Many urologists may only see one or two cases in a lifetime of practice, so awareness of this therapeutic alternative may be limited. Because penile-sparing approaches are being used more frequently in centers with experience, referral to such centers is recommended. This review is designed to inform radiation oncologists, urologists, and other physicians about the role of radiation therapy in the treatment of carcinoma of the penis. Carcinoma of the penis is most frequently located on the glans and prepuce (8).