PURPOSE: To determine if androgen-deprivation therapy (ADT) has an impact on cause-specific, biochemical progression-free, or overall survival after prostate brachytherapy. METHODS AND MATERIALS: From April 1995 through June 2002, 938 consecutive patients underwent brachytherapy for clinical Stage T1b to T3a (2002 AJCC) prostate cancer. All patients underwent brachytherapy more than 3 years before analysis. A total of 382 patients (40.7%) received ADT with a duration of 6 months or less in 277 and more than 6 months in 105. The median follow-up was 5.4 years. Multiple clinical, treatment, and dosimetric parameters were evaluated as predictors of cause-specific, biochemical progression-free, and overall survival. RESULTS: The 10-year cause-specific, biochemical progression-free, and overall survival rates for the entire cohort were 96.4%, 95.9%, and 78.1%, respectively. Except for biochemical progression-free survival in high-risk patients, ADT did not statistically impact any of the three survival categories. A Cox linear-regression analysis demonstrated that Gleason score was the best predictor of cause-specific survival, whereas percent-positive biopsies, prostate volume, and risk group predicted for biochemical progression-free survival. Patient age and tobacco use were the strongest predictors of overall survival. One hundred two patients have died, with 80 of the deaths a result of cardiovascular disease (54) and second malignancies (26). To date, only 12 patients have died of metastatic prostate cancer. CONCLUSIONS: After brachytherapy, androgen-deprivation therapy did not have an impact on cause-specific or overall survival for any risk group; however, ADT had a beneficial effect on biochemical progression-free survival in high-risk patients. Cardiovascular disease and second malignancies far outweighed prostate cancer as competing causes of death.
PURPOSE: To determine if androgen-deprivation therapy (ADT) has an impact on cause-specific, biochemical progression-free, or overall survival after prostate brachytherapy. METHODS AND MATERIALS: From April 1995 through June 2002, 938 consecutive patients underwent brachytherapy for clinical Stage T1b to T3a (2002 AJCC) prostate cancer. All patients underwent brachytherapy more than 3 years before analysis. A total of 382 patients (40.7%) received ADT with a duration of 6 months or less in 277 and more than 6 months in 105. The median follow-up was 5.4 years. Multiple clinical, treatment, and dosimetric parameters were evaluated as predictors of cause-specific, biochemical progression-free, and overall survival. RESULTS: The 10-year cause-specific, biochemical progression-free, and overall survival rates for the entire cohort were 96.4%, 95.9%, and 78.1%, respectively. Except for biochemical progression-free survival in high-risk patients, ADT did not statistically impact any of the three survival categories. A Cox linear-regression analysis demonstrated that Gleason score was the best predictor of cause-specific survival, whereas percent-positive biopsies, prostate volume, and risk group predicted for biochemical progression-free survival. Patient age and tobacco use were the strongest predictors of overall survival. One hundred two patients have died, with 80 of the deaths a result of cardiovascular disease (54) and second malignancies (26). To date, only 12 patients have died of metastatic prostate cancer. CONCLUSIONS: After brachytherapy, androgen-deprivation therapy did not have an impact on cause-specific or overall survival for any risk group; however, ADT had a beneficial effect on biochemical progression-free survival in high-risk patients. Cardiovascular disease and second malignancies far outweighed prostate cancer as competing causes of death.
Authors: Bethany B Barone; Hsin-Chieh Yeh; Claire F Snyder; Kimberly S Peairs; Kelly B Stein; Rachel L Derr; Antonio C Wolff; Frederick L Brancati Journal: JAMA Date: 2008-12-17 Impact factor: 56.272
Authors: Giovanni Fellin; Maria A Mirri; Luigi Santoro; Barbara A Jereczek-Fossa; Claudio Divan; Salvatore Mussari; Francesco Ziglio; Beniamino La Face; Fernando Barbera; Michela Buglione; Laura Bandera; Barbara Ghedi; Nadia G Di Muzio; Andrea Losa; Paola Mangili; Luciano Nava; Renato Chiarlone; Nunzia Ciscognetti; Emilio Gastaldi; Federica Cattani; Ruggero Spoto; Andrea Vavassori; Francesca R Giglioli; Alessia Guarneri; Valentina Cerboneschi; Marcello Mignogna; Mauro Paoluzzi; Valentina Ravaglia; Costanza Chiumento; Stefania Clemente; Vincenzo Fusco; Roberto Santini; Marco Stefanacci; Francesco P Mangiacotti; Marco Martini; Tiziana Palloni; Giuseppe Schinaia; Grazia Lazzari; Giovanni Silvano; Stefano Magrini; Umberto Ricardi; Riccardo Santoni; Roberto Orecchia Journal: Br J Radiol Date: 2016-07-07 Impact factor: 3.039
Authors: Dong Soo Park; In Hyuck Gong; Don Kyung Choi; Jin Ho Hwang; Hyun Soo Shin; Jong Jin Oh Journal: Yonsei Med J Date: 2013-09 Impact factor: 2.759