+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Prostate cancer death is unlikely in high-risk patients following quality permanent interstitial brachytherapy



Prostate cancer death is unlikely in high-risk patients following quality permanent interstitial brachytherapy



Bju International 107(2): 226-232



To evaluate cause-specific survival (CSS), biochemical progression-free survival (bPFS) and overall survival (OS) in high-risk prostate cancer brachytherapy patients. From April 1995 to June 2005, 284 patients with high-risk prostate cancer (Gleason score ≥ 8 or prostate-specific antigen > 20 ng/mL or clinical stage ≥ T2 c) underwent brachytherapy. Supplemental external beam radiation therapy was given to 257 (90.5%) patients and 179 (63.0%) received androgen deprivation therapy (ADT). Median follow up was 7.8 years. The median post-implant day 0 D90 was 118.9% of prescription dose. Patients with metastatic prostate cancer or castrate-resistant disease without obvious metastases who died of any cause were classified as dead from prostate cancer. Multiple parameters were evaluated for impact on survival. Twelve-year CSS, bPFS and OS were 94.2%, 89.0% and 69.7%. On multivariate analysis, bPFS was best predicted by percent positive biopsies and ADT. The analysis failed to identify any predictors for CSS, while OS was highly correlated with patient age, percent positive biopsies and diabetes. Fourteen percent of patients died from diseases of the heart, while 8%, 8% and 6% of patients died from non-prostate cancer, other causes and prostate cancer, respectively. When OS was stratified by patients with 0-3 vs ≥ 4 comorbidities, the 12-year OS was 73.0% and 52.7% (P = 0.036). High-quality brachytherapy results in favourable bPFS and CSS for high-risk patients. Death from diseases of the heart is more than twice as likely as death from prostate cancer. Strategies to improve cardiovascular health may positively impact OS.

(PDF emailed within 0-6 h: $19.90)

Accession: 055239866

Download citation: RISBibTeXText

PMID: 20707801

DOI: 10.1111/j.1464-410X.2010.09486.x


Related references

Biochemical outcome for hormone-naïve patients with high-risk prostate cancer managed with permanent interstitial brachytherapy and supplemental external-beam radiation. Cancer Journal 8(4): 322-327, 2002

High-risk prostate cancer with Gleason score 8-10 and PSA level ≤15 ng/mL treated with permanent interstitial brachytherapy. International Journal of Radiation Oncology, Biology, Physics 81(4): 992-996, 2012

Does hormonal manipulation improve biochemical outcome for intermediate or high risk prostate cancer managed with permanent interstitial brachytherapy. International Journal of Radiation Oncology Biology Physics 54(2 Supplement): 258, 2002

Comparison between external beam radiotherapy (70 Gy/74 Gy) and permanent interstitial brachytherapy in 890 intermediate risk prostate cancer patients. RadioTherapy and Oncology 103(2): 223-227, 2012

Permanent interstitial low-dose-rate brachytherapy for patients with low risk prostate cancer: An interim analysis of 312 cases. Strahlentherapie und Onkologie 191(4): 303-309, 2015

Long-term outcome for very high-risk prostate cancer treated primarily with a triple modality approach to include permanent interstitial brachytherapy. BrachyTherapy 11(4): 250-255, 2012

Radical prostatectomy versus high dose permanent prostate brachytherapy using iodine-125 seeds for patients with high risk prostate cancer: a matched cohort analysis. World Journal of Urology 31(6): 1511-1517, 2014

Primary Gleason grade 4 impact on biochemical recurrence after permanent interstitial brachytherapy in Japanese patients with low- or intermediate-risk prostate cancer. International Journal of Radiation Oncology, Biology, Physics 82(2): E219-E223, 2012

Re: Permanent interstitial brachytherapy for the management of carcinoma of the prostate gland. Re: Health related quality of life in men with prostate cancer. Journal of Urology 170(6 Pt 1): 2391-2; Author Reply 2392, 2003

Does hormonal manipulation in conjunction with permanent interstitial brachytherapy, with or without supplemental external beam irradiation, improve the biochemical outcome for men with intermediate or high-risk prostate cancer?. BJU International 91(1): 23-29, January, 2003

Interstitial brachytherapy for early stage prostate cancer Reduced toxicity with high-dose rate brachytherapy monotherapy compared to permanent palladium seed implants. International Journal of Radiation Oncology Biology Physics 54(2 Supplement): 262, 2002

Re Permanent interstitial brachytherapy for the management of carcinoma of the prostate gland and Re Health related quality of life in men with prostate cancer Reply by Merrick et al. Journal of Urology 170(6 Part 1): 2392, December, 2003

Transperineal interstitial permanent prostate brachytherapy for Japanese prostate cancer patients in Hawaii. International Journal of Urology 11(9): 728-734, 2004

Treatment outcomes with permanent brachytherapy in high-risk prostate cancer patients stratified into prognostic categories. BrachyTherapy 14(6): 766-772, 2016