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Takehiro Inoue

Publications and source records attributed to Takehiro Inoue.

At least 19 recordsLinked to original sources
PubMed2007

Novel correction methods as alternatives for the six-dimensional correction in CyberKnife treatment.

PURPOSE: During CyberKnife treatment, the 6D correction method is used to correct patient positional errors, including rotational ones. We developed novel correction methods for translating rotational errors into 3D, with the aim of making their correction safer than with 6D correction and as accurate as possible. MATERIALS AND METHODS: These novel correction methods were named the gravity correction and the beam correction method. With the gravity correction method, the beam coordinates after rotation are corrected to match the tumor gravity point with 3D translational components translated by the affine transformation matrix. For beam correction, the beam coordinates are corrected to match the translated tumor target coordinates for each treatment beam. The effectiveness and impact of these methods were demonstrated by means of dose volume histogram (DVH) shift evaluation. For analysis of the treatment data of 10 patients, the treatment beam was rotated in three patterns of rotational degree and corrected with the two methods. The amount of tumor gravity point shift in the rotation was also calculated, and the deterioration of the tumor DVH was studied. RESULTS: In the case of +/-1 degrees , +/-3 degrees , and +/-1 degrees rotation for the X, Y, Z axes, the tumor gravity point of all 10 patients moved around 2.4 mm on average. Tumor DVH was deteriorated worse as the distance between the tumor gravity point and the rotational origin became more distant. With the planned D90, which represents the dose above which 90% of the tumor volume is irradiated set at 100%, the postrotational average D90 dose deteriorated to 96.12% after (+/-1 degrees , +/-3 degrees , and +/-1 degrees ) rotation. The dose was improved to 99.9% (SD +/- 0.41) after the gravity correction, or to 99.87% (SD +/- 0.55) after the beam correction. CONCLUSION: The correction methods developed by us can correct tumor DVH findings to the same degree as with 6D correction and are safer because the movement required for correcting the linac is not rotational but translational only.

Head and Neck Neoplasms↗
PubMed2006

Preliminary results of phase I trial of oral uracil/tegafur (UFT), leucovorin plus irinotecan and radiation therapy for patients with locally recurrent rectal cancer.

BACKGROUND: Surgical attempts for locally recurrent rectal cancer often fail due to local re-recurrence and distant metastasis. Preoperative chemoradiation may enhance better local control and survival. The aim of this study was to assess the safety of oral uracil and tegafur (UFT) plus leucovorin (LV), and irinotecan combined with radiation and determine the maximum-tolerated dose (MTD) and dose limiting toxicity (DLT) of the triple drug regimen. PATIENTS AND METHODS: Patients with locally recurrent rectal cancer received escalating doses of irinotecan on days 1, 8, 15, and 22 (starting at 30 mg/m2, with 10 mg increments between consecutive cohorts) and fixed doses of UFT (300 mg/m2) plus LV (75 mg/day) on days 3 to 7, 10 to 14, 17 to 21, and 24 to 28. Radiation was given 5 days per week totaling 40 to 50 Gy (2Gy/day). RESULTS: Six patients were treated at the starting dose, and 2 received the full scheduled chemoradiotherapy. The other 4 patients had grade 3 diarrhea and diarrhea was the DLT. One patient had partial response and he had subsequently radical surgical resection. Median progression free survival for local recurrence was 320 days. CONCLUSION: Irinotecan plus UFT/LV with concomitant radiotherapy in patients with locally recurrent rectal cancer was not feasible due to diarrhea in this setting. Modification of the treatment is needed.

Journal Article↗
PubMed2006

High-dose-rate brachytherapy without external beam irradiation for locally advanced prostate cancer.

BACKGROUND AND PURPOSE: High-dose-rate brachytherapy (HDR-BT) had been used only in combination with external beam irradiation (EBI) until our previously reported first trial of HDR-BT alone without EBI. The purpose of the current report is to evaluate the feasibility, toxicity and efficacy of this regimen, with more patient accrual and longer follow-up. MATERIAL AND METHODS: From 1995 through 2004, 111 patients with localized prostate cancer were treated with HDR-BT without EBI. Fifteen patients were considered as low-risk, 28 as intermediate-risk, and 68 as high-risk. The prescribed dose was 48 Gy/8 fractions/5 days or 54 Gy/9 fractions/5 days. Median follow-up time was 27 months (range 5-119). RESULTS: All the patients completed the treatment regimen. The 3- and 5-year PSA failure-free rates were 83% and 70%, and the local control rates 100% and 97%. The maximum toxicities observed were Grade 3 by CTCAE v3.0 (6 acute, 1 chronic). CONCLUSIONS: HDR-BT without EBI was feasible and its toxicity acceptable. Short-term tumor control was promising, even for locally advanced cases. More patient accrual and longer follow-up are needed to confirm the efficacy of this novel approach.

Aged↗
PubMed2006

Phase I/II trial of hyperfractionated accelerated chemoradiotherapy for unresectable advanced pancreatic cancer.

BACKGROUND: We conducted a Phase I/II study to evaluate the local efficacy and toxicity of hyperfractionated accelerated radiotherapy (HART) combined with 5-fluorouracil (5-FU) and cisplatin (CDDP) in patients with unresectable advanced pancreatic cancer. METHODS: Thirty-five patients (15 with Stage 4A and 20 with Stage 4B disease according to TNM classification) were enrolled between August 1997 and August 2001 into this Phase I/II trial. All patients received concurrent HART (1.5 Gy twice daily separated by 6 h for 5 days per week), 5-FU (375 mg/m(2) given as continuous intravenous infusion), and CDDP (2 mg/m(2) given as 30-min infusion just before each fraction of irradiation). In the Phase I trial, the total dose of radiation was escalated from 27 to 45 Gy. RESULTS: Twenty-one patients were enrolled in the Phase I study and six patients were given the final planned dose (45 Gy) which did not exceed the maximum tolerated dose. Eleven patients (52.4%) suffered from Grade 3 or worse neutropenia. Vomiting and mucositis were observed in 21 (100%) and 12 (57.1%) patients, respectively. An additional 14 patients were entered in the Phase II trial and received a total dose of 45 Gy, which is recommended in Phase I trial. Concerning the local tumor control of 20 patients with the recommended regimen, 7 patients (35%) achieved partial response, 10 (50%) remained stable and local progressive disease occurred in 3 (15%). The median survival time and the overall 1-year survival rate were 11.2 months and 40.0%, respectively, in 20 patients who received the recommended regimen. In Stage 4A patients, they were 13.0 months and 70.0%, respectively. The trend of toxicities in patients with the recommended regimen was almost the same as that observed in the Phase I study. CONCLUSION: The chosen combined modality treatment was well tolerated, and showed an expected local efficacy for the treatment of unresectable advanced pancreatic cancer.

Aged↗
PubMed2006

Intracavitary brachytherapy for carcinoma of the uterine cervix--comparison of HDR (Ir-192) and MDR (Cs-137).

PURPOSE: To compare the results of high dose rate (HDR) (Ir-192) and medium dose rate (MDR) (Cs-137) intracavitary brachytherapy (ICRT) for carcinoma of the uterine cervix. MATERIALS AND METHODS: Between May 1991 and March 2001, a total of 206 patients with Stage I-IVA previously untreated cervical cancer were treated with ICRT combined with external beam radiotherapy (EBRT). HDR was administered to a total of 135 patients: 22 patients in Stage I, 49 in Stage II, 56 in Stage III, and eight in Stage IVA. MDR was administered to a total of 71 patients: six patients in Stage I, 27 in Stage II, 33 in Stage III, and five in Stage IVA. The MDR at point A was 30 Gy/hour for HDR and 1.7 Gy/hour for MDR treatment, and the corresponding median follow-up periods for survivors were 55 and 68 months. RESULTS: For the HDR group, 5-year cause-specific survival rates were 90%, 78%, 53% and 33% for Stages I, II, III, and IVA, respectively. For the MDR group, the corresponding rates were 100%, 76%, 51%, and 40%. In the HDR group, 19 patients (14%) developed Grade 2 or higher late complications, and, in the MDR group, four patients (6%) did. CONCLUSIONS: There was no statistically significant difference in cause-specific survivals between the results of HDR and MDR brachytherapy for cervical cancer. The incidence of late complications tended to be higher for the HDR group than for the MDR group, but did not show a statistically significant difference (p=0.07).

Adult↗
PubMed2006

High-dose-rate brachytherapy combined with long-term hormonal therapy for high-risk prostate cancer: results of a retrospective analysis.

PURPOSE: High-dose-rate (HDR) brachytherapy combined with hormonal therapy (HTx), without the addition of external beam radiation therapy (EBRT) for high-risk prostate cancer was evaluated retrospectively. MATERIALS AND METHODS: Between May 1995 and April 2002, 35 patients with prostate cancer [Stage > or = T2b (UICC 1997) or tumor grading=3 or prostate-specific antigen (PSA) level > or = 20 ng/mL] were treated with HDR brachytherapy combined with HTx. Most patients (74%) had two or more of these factors. All patients received Iridium-192 HDR brachytherapy with a total dose of 54 Gy/9 fractions/5 days (48 Gy/8 fractions/5 days for the first 6 cases) in one implant session. The median neoadjuvant HTx [luteinizing hormone-releasing hormone (LH-RH) agonist and antiandrogen] period was 7 months. The median adjuvant HTx (ATH) (LH-RH agonist) period was 40 months, and median follow-up was 57 months (range, 23-117 months). RESULTS: The 5-year actuarial biochemical control, local control, and disease-free rates were 62%, 96%, and 76% respectively. No patients experienced local and/or regional relapse without distant progression. The 5-year actuarial cause-specific survival and overall survival rates were 89% and 87%, respectively. The acute and late toxicity were moderate and well tolerated. CONCLUSION: HDR brachytherapy plus long-term HTx is at least as effective as conventional EBRT plus long-term HTx.

Aged↗
PubMed2006

Postoperative irradiation for pterygium: retrospective analysis of 1,253 patients from the Osaka University Hospital.

BACKGROUND AND PURPOSE: Irradiation of ocular pterygium is considered a valuable treatment supplementation after surgical therapy. Since prospective randomized trials are scare and only limited patient data are available, the aim of this study was to evaluate the patient population treated with fractioned 90Sr irradiation after surgical pterygium resection. PATIENTS AND METHODS: Between September 1993 and March 2001, 1,147 patients with pterygium lesions (1,320 lesions) were treated surgically and with 90Sr postoperative beta-irradiation. A total dose of 30 Gy was used for patients treated within 48 h after surgery, while those treated>48 h postoperatively received a total dose of 35 Gy. A minimum follow-up period of 3 months was required for inclusion in the analysis, and 1,253 lesions were ultimately analyzed. RESULTS: Recurrence of the pterygium after postoperative 90Sr irradiation was observed in 97 of 1,253 cases (7.7%). Statistical analysis (uni- and multivariate) revealed, that male gender, younger age (<40 years), prior treatment (surgery and radiotherapy) and immediate irradiation (<2 h after surgery) were negative predictors for local recurrence. Temporary radiotherapy-induced side effects were observed in 15.2% of patients, including moderate conjunctivitis, local pain, visual disturbance and photophobia or an increase in tear flow. However, no long-term serious side effects were documented. CONCLUSION: 90Sr irradiation of pterygium after surgery represents a safe and effective treatment option to prevent disease recurrence. The data obtained in this study indicate that a certain interval after surgery might improve therapy outcome.

Adult↗
PubMed2005

Optimization of dose distribution for HDR brachytherapy of the prostate using Attraction-Repulsion Model.

PURPOSE: To optimize dose distribution for high-dose-rate brachytherapy for prostate cancer, we have developed a new algorithm named Attraction-Repulsion Model (ARM). In this study, we compared the ARM with geometric optimization (GO). METHODS AND MATERIALS: The ARM was used to optimize the dose distribution by finding the best dwell time combination. ARM requires grids inside the clinical target volume (CTV) and critical organs. These grids generate attraction or repulsion based on specific dose constraints. After calculations were performed repeatedly until the attraction and repulsion forces reached equilibrium, the optimal dwell time distribution was established. We compared the ARM with GO for 10 patients using dose-volume histograms. RESULTS: The CTV ranged from 23 to 48 cc, and the CTV V150 ranged from 52% to 79%, and 23% to 44% for GO and ARM, respectively. This indicates that the dose homogeneity indices, as well as the conformal indices, were higher for ARM than for GO. The urethra V150 was 0-99% and 0-1% for GO and ARM, respectively. CONCLUSION: The ARM proved to be superior to GO in minimizing the dose to normal structures and in improving dose homogeneity for the target while reducing the dose to normal tissues.

Algorithms↗
PubMed2005

Antegrade selective cerebral perfusion with mild hypothermic systemic circulatory arrest during thoracic aortic surgery.

OBJECTIVE: Antegrade selective cerebral perfusion (ASCP) and retrograde cerebral perfusion (RCP) have proven to be reliable methods of brain protection during aortic surgery. These techniques are usually accompanied by systemic circulatory arrest with moderate hypothermia (24-28 degrees C) or deep hypothermia (18-24 degrees C). However, hypothermia can lead to various problems. The present study therefore reports results for thoracic aorta replacement using ASCP with mild hypothermic systemic arrest (28-32 degrees C). DESIGN: Between 1995 and 2003, 68 consecutive patients underwent repair of the ascending aorta and/or aortic arch. Mild hypothermic ASCP was utilized in 31 cases, moderate hypothermic ASCP in 20, and deep hypothermic RCP in 17. Various parameters were compared between the mild hypothermic ASCP, moderate hypothermic ASCP, and RCP. RESULTS: Hospital mortality was 10.3%, with no significant differences observed between any groups. Permanent neurological dysfunction was 8.8%, and no significant differences were observed between any groups. Mild hypothermic ASCP displayed significantly decreased transfusion volume, intubation time, and ICU stay. CONCLUSIONS: Use of ASCP with mild hypothermic systemic circulatory arrest during aortic surgery resulted in acceptable hospital mortality and neurological outcomes. ASCP with mild hypothermic arrest allows decreased transfusion volume and reduced duration of intubation and ICU stay.

Aged↗
PubMed2005

Concomitant aortoaxillary bypass and coronary artery bypass grafting.

The optimal revascularization strategy for patients with subclavian and coronary artery disease has not been established. This study assessed the mid-term clinical outcome of concomitant aortoaxillary bypass and coronary artery bypass grafting in 5 patients. A ring-reinforced polytetrafluoroethylene graft was attached to the ascending aorta and led to the proximal segment of the axillary artery via the pleural cavity. Patients were followed up for 2-10 years (mean, 5.4 +/- 3.4 years). Postoperative aortography and angiography demonstrated patent aortoaxillary and coronary bypass grafts in the short-term follow-up of all patients. Two patients with Takayasu aortitis needed re-operations for recurrent angina and annuloaortic dilatation. Another patient required removal of the aortoaxillary bypass graft because of infection, and subsequently underwent a left femoroaxillary bypass one year after the original procedure. Subclavian steal phenomenon did not occur. Aortoaxillary bypass with coronary artery bypass may be an effective option for patients with co-existing subclavian and coronary artery disease.

Aged↗
PubMed2005

Urinary 8-hydroxy-2'-deoxyguanosine excretion as a biomarker for estimating DNA oxidation in patients undergoing external radiotherapy and/or brachytherapy.

Urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) is considered to be a biomarker of cellular oxidative stress and to be associated with carcinogenesis. To estimate the oxidative stress caused by radiotherapy, we used the enzyme-linked immunosorbent assay (ELISA) to monitor urinary 8-OHdG levels in 72 patients undergoing radiotherapy. Subjects consisted of 23 breast cancer patients undergoing post-operative external radiotherapy for breast conserving therapy, 12 tongue and seven prostate cancer patients undergoing interstitial radiotherapy, 19 esophageal cancer patients undergoing external radiotherapy and chemotherapy, and 11 cervical cancer patients undergoing external radiotherapy and brachytherapy with or without chemotherapy. Before radiotherapy, cervical cancer patients showed a higher urinary 8-OHdG level (16.0+/-8.8 ng/mg) than breast cancer patients (5.3+/-5.5 ng/mg, p=0.001). In the other three groups, urinary 8-OHdG levels were in the medium range (prostate cancer patients: 6.6+/-6.3 ng/mg; esophageal cancer patients: 8.8+/-11.1 ng/mg; tongue cancer patients: 10.2+/-6.7 ng/mg). Radiotherapy did not cause changes in the excretion level of urinary 8-OHdG in patients with breast, esophageal and tongue cancer. However, radiotherapy reduced 8-OHdG excretion levels in patients with cervical cancer, whereas interstitial radiotherapy transiently increased these levels in patients with prostate cancer.

8-Hydroxy-2'-Deoxyguanosine↗
PubMed2005

Pelvic irradiation-induced eosinophilia is correlated to prognosis of cervical cancer patients and transient elevation of serum interleukin 5 level.

PURPOSE: To determine the significance of eosinophilia and serum interleukin 5 (IL-5) levels induced by radiotherapy in patients with gynecological cancer. MATERIALS AND METHODS: First, we examined changes in the number of eosinophils before and during radiotherapy in 145 patients with cervical cancer who underwent external radiotherapy and brachytherapy. Eosinophilia was defined as > or =10% eosinophils or > or =500 eosinophils/mm3. Next, we determined serum IL-5 levels prospectively in 20 patients, comprising 18 cases of cervical cancer, one of uterine corpus cancer, and one of vaginal cancer. RESULTS: Eosinophilia was seen in 88 patients (61%). Patients with advanced disease stage IV showed 32% eosinophila, lower than those of stage I (63%), II (69%), and III (65%) disease patients (p=0.03). The 5-year cause-specific survival rate was 76% for patients with eosinophilia (+) and 53% for patients without eosinophilia (p=0.0003). Thus, eosinophilia correlates to stage classification and a good prognosis. Of the 20 patients studied prospectively, the six with elevated serum IL-5 level at one week (6/20=30%) all showed eosinophilia (100%), whereas only six of the other 14 patients had eosinophilia (43%, p=0.04). CONCLUSION: Radiotherapy induced transient elevation of serum IL-5 levels and is related with eosinophilia, which is correlated to prognosis.

Adult↗
PubMed2004

An optimization algorithm of dose distribution using attraction-repulsion model (application to low-dose-rate interstitial brachytherapy).

PURPOSE: To optimize dose distribution for prostate cancer in low-dose-rate interstitial brachytherapy, we have developed a new algorithm named the Attraction-Repulsion Model. The purpose was to find the optimal source configuration. METHODS AND MATERIALS: The Attraction-Repulsion Model is used to optimize the dose distribution by finding the best seed configuration. We arranged grids at intervals of a certain space inside and established target and critical organs as areas of interest. We can make an attribute for grids, and the grids show attraction or repulsion depending on dose delivered from source. Source position is changed by the forces that the grids impose to the sources. A calculation was done repeatedly until the attraction and repulsion forces reached a balance. The optimal configuration was established when the sources reached a stable distribution in time. To evaluate the optimization plan, dose-volume histograms were used. RESULTS: Source configuration can be optimized automatically. The calculation time was approximately 5 min. The V100, V150, V200, and D90 of the target were 95%, 39%, 9%, and 157 Gy, respectively. V150 of the urethra and V80 of the rectum were 2% and 0%, respectively. CONCLUSION: This method can optimize the dose distribution objectively.

Algorithms↗
PubMed2004

Surgical treatment of infective endocarditis complicated by intracranial hemorrhage in a patient with hypertrophic obstructive cardiomyopathy.

A patient with hypertrophic obstructive cardiomyopathy developed mitral regurgitation due to infective endocarditis. The patient, a 29-year-old man with a 16-year history of a severe obstructive form of hypertrophic obstructive cardiomyopathy (left ventricular outflow gradient more than 100 mmHg), was admitted with bacteremia. During medical therapy with antibiotics for six months, the patient suffered an intracranial hemorrhage without a mycotic aneurysm and developed severe mitral regurgitation due to the infective endocarditis. One month after clinical stability of the cerebral damage, the patient underwent a combined mitral valve replacement and transaortic septal myectomy. Postoperative echocardiography revealed that the left ventricular outflow gradient had decreased to 15 mmHg. Ten months after the combined operation, the patient was well and asymptomatic.

Adult↗
PubMed2004

Lymph node metastasis of early oral tongue cancer after interstitial radiotherapy.

PURPOSE: To examine the prognostic factors for lymph node metastasis after brachytherapy for early (T1-T2N0M0) oral tongue cancer. METHODS AND MATERIALS: We reviewed the records of 571 patients (500 low dose rate and 71 high dose rate) treated at Osaka University Hospital between 1967 and 1999. RESULTS: Patients with lymph node metastasis had tumor with an average diameter of 26 +/- 8 mm and a thickness of 9 +/- 5 mm; for patients without lymph node metastasis, the corresponding dimensions were 23 +/- 8 mm and 7.5 +/- 4 mm (p = 0.0004 and 0.001, respectively). After 5 years, the ulcerative (48%) and indurative/infiltrative (39%) types showed a higher ratio of nodal involvement than the exophytic (31%) and superficial (19%) types (p <0.0001). Multivariate analysis showed ulceration (p = 0.006) and a thickness of <or =6 mm (p = 0.04) to be statistically significant predisposing factors for lymph node metastasis. The lymph node control rate was 68% in 1967-1979, 71% in 1980-1990, and 66% in 1990-1999; the corresponding successful salvage rates for lymph node metastasis were 43%, 33%, and 58% (p = 0.04). CONCLUSION: The appearance of the tumor, especially the presence or absence of ulceration and the diameter and thickness, are useful prognostic indicators for lymph node metastasis. Although the rates of lymph node metastasis did not change, the salvage outcome for recurrence after interstitial radiotherapy has recently improved.

Adult↗
PubMed2004

Impact of mitochondrial DNA on radiation sensitivity of transformed human fibroblast cells: clonogenic survival, micronucleus formation and cellular ATP level.

The purpose of this study was to evaluate the impact of mitochondrial DNA (mtDNA) on the radiation sensitivity of transformed human fibroblast cells. The p+ and p0 human fibroblast cell lines were used, which carry wild-type mtDNA and no mtDNA, respectively. Clonogenic radiosensitivity was evaluated by colony formation assay and micronucleus (MN) formation assay. The ATP assay was then used to address the discrepancy between the results of the former two assays. Despite the lack of a significant difference in survival in the colony formation assay, p+ and p0 cells exhibited high and low radiosensitivities, respectively, in the MN formation assay (P < 0.003). This difference in MN formation correlated with high and low levels of cellular ATP content in p+ and p0 cells (P = 0.004). The addition of antimycin A suppressed differences in both MN formation and cellular ATP content. In the transformed human fibroblast cells we used, mtDNA played an important role in radiation-induced MN formation that was correlated with the levels of cellular ATP content. These results may imply the presence of an MN expression pathway that is dependent on the intrinsic ATP level and that may be compensated and lead to an equivalent level of clonogenic survival.

Adenosine Triphosphate↗
PubMed2003

High-dose-rate brachytherapy as monotherapy for localized prostate cancer: a retrospective analysis with special focus on tolerance and chronic toxicity.

PURPOSE: To examine retrospectively fractionated high-dose-rate brachytherapy as monotherapy for localized prostate cancer with special focus on tolerance and toxicity, especially chronic toxicity. MATERIALS AND METHODS: Between May 1995 and October 2001, 43 patients with localized prostate cancer were treated with high-dose-rate brachytherapy without external beam irradiation at Osaka University Hospital. The stage was T1, T2, T3, and T4 in 8, 14, 18, and 3 patients, respectively. The adenocarcinoma was well, moderately, or poorly differentiated in 12, 16, and 15 patients, respectively. The median initial prostate-specific antigen level was 19.3 ng/mL (range 3.8-233.0). Thirty-eight patients also received hormonal therapy. Metallic needles were implanted transperineally under real-time ultrasound guidance, followed by a dose optimization program. Patients were irradiated twice daily at intervals of >6 h. A total dose of 54 Gy in nine fractions within 5 days (48 Gy in eight fractions within 5 days for the first 7 cases) was administered in one implant session. The median follow-up was 24 months (range 1-76). RESULTS: Radiation Therapy Oncology Group acute toxicity of Grade 4, 2, and 1 occurred in 1 (2%), 12 (28%), and 8 (19%) patients, respectively. Five patients had late toxicity: one with rectal ulcer (Grade 2) and four with rectal bleeding (Grade 1). The volume receiving 100% of the prescribed dose showed significant correlations with the incidence of acute and chronic toxicities (p = 0.005 and p = 0.014, respectively). The 3-year actuarial overall survival, local control, and biochemical no evidence of disease rate was 94%, 100%, and 55%, respectively. The crude biochemical control rate for low, intermediate, and high-risk patients was 100% (5 of 5), 80% (8 of 10), and 61% (17 of 28), respectively. CONCLUSIONS: High-dose-rate brachytherapy as monotherapy was found to be feasible and well tolerated. It showed a low chronic toxicity rate without any event of Radiation Therapy Oncology Group of Grade 3 or greater.

Adenocarcinoma↗