PURPOSE: To analyze the effect of biologically effective dose (BED) values on prostate-specific antigen (PSA) failure and posttreatment biopsy. METHODS AND MATERIALS: From 1990 to 2003, 1,377 patients had prostate brachytherapy alone (I-125 or Pd-103) (571), hormonal and brachytherapy (371), and trimodality therapy (hormonal, implant, and external beam) (435). Dose was defined as the D90 (dose delivered to 90% of the gland from the dose-volume histogram). RESULTS: Freedom from PSA failure (FFPF) at 10 years was 87%. The 10-year FFPF for BED<100, >100-120, >120-140, >140-160, <160-180, >180-200, and >200 were 46%, 68%, 81%, 85.5%, 90%, 90%, and 92%, respectively (p<0.0001). BED and Gleason score had the greatest effect, with p values of p<0.0001 in multivariate analysis. Posttreatment positive biopsy rate was 7% (31/446). The positive biopsy rates for BED<or=100, >100-120, >120-140, >140-160, >160-180, >180-200, and >200 were 24% (8/33), 15% (3/20), 6% (2/33), 6% (3/52), 7% (6/82), 1% (1/72), and 3% (4/131), respectively (p<0.0001). BED was the most significant predictor of biopsy outcome in multivariate analysis (p=0.006). CONCLUSIONS: Biologically effective dose equations provide a method of comparing different isotopes and combined therapies in the brachytherapy management of prostate cancer. The effects of BED on FFPF and posttreatment biopsy demonstrate a strong dose-response relationship.
PURPOSE: To analyze the effect of biologically effective dose (BED) values on prostate-specific antigen (PSA) failure and posttreatment biopsy. METHODS AND MATERIALS: From 1990 to 2003, 1,377 patients had prostate brachytherapy alone (I-125 or Pd-103) (571), hormonal and brachytherapy (371), and trimodality therapy (hormonal, implant, and external beam) (435). Dose was defined as the D90 (dose delivered to 90% of the gland from the dose-volume histogram). RESULTS: Freedom from PSA failure (FFPF) at 10 years was 87%. The 10-year FFPF for BED<100, >100-120, >120-140, >140-160, <160-180, >180-200, and >200 were 46%, 68%, 81%, 85.5%, 90%, 90%, and 92%, respectively (p<0.0001). BED and Gleason score had the greatest effect, with p values of p<0.0001 in multivariate analysis. Posttreatment positive biopsy rate was 7% (31/446). The positive biopsy rates for BED<or=100, >100-120, >120-140, >140-160, >160-180, >180-200, and >200 were 24% (8/33), 15% (3/20), 6% (2/33), 6% (3/52), 7% (6/82), 1% (1/72), and 3% (4/131), respectively (p<0.0001). BED was the most significant predictor of biopsy outcome in multivariate analysis (p=0.006). CONCLUSIONS: Biologically effective dose equations provide a method of comparing different isotopes and combined therapies in the brachytherapy management of prostate cancer. The effects of BED on FFPF and posttreatment biopsy demonstrate a strong dose-response relationship.
Authors: Michael J Zelefsky; Gil'ad N Cohen; Walter R Bosch; Lisa Morikawa; Najma Khalid; Cheryl L Crozier; W Robert Lee; Anthony Zietman; Jean Owen; J Frank Wilson; Phillip M Devlin Journal: Brachytherapy Date: 2012-07-21 Impact factor: 2.362
Authors: Sarah L Kerns; Richard Stock; Nelson Stone; Michael Buckstein; Yongzhao Shao; Christopher Campbell; Lynda Rath; Dirk De Ruysscher; Guido Lammering; Rosetta Hixson; Jamie Cesaretti; Mitchell Terk; Harry Ostrer; Barry S Rosenstein Journal: Int J Radiat Oncol Biol Phys Date: 2012-09-26 Impact factor: 7.038
Authors: Ravinder Nath; William S Bice; Wayne M Butler; Zhe Chen; Ali S Meigooni; Vrinda Narayana; Mark J Rivard; Yan Yu Journal: Med Phys Date: 2009-11 Impact factor: 4.071
Authors: Sarah L Kerns; Richard G Stock; Nelson N Stone; Seth R Blacksburg; Lynda Rath; Ana Vega; Laura Fachal; Antonio Gómez-Caamaño; Dirk De Ruysscher; Guido Lammering; Matthew Parliament; Michael Blackshaw; Michael Sia; Jamie Cesaretti; Mitchell Terk; Rosetta Hixson; Barry S Rosenstein; Harry Ostrer Journal: Radiother Oncol Date: 2013-05-26 Impact factor: 6.280