PURPOSE: To present preliminary outcomes of pulsed dose rate brachytherapy (PDR-BT), external beam radiotherapy (EBRT), and hormonal manipulation, for prostate cancer. PATIENTS AND METHODS: Between December 1999 and January 2005, 165 consecutive patients with Stage T1-T3, N0, M0 prostate cancer were treated. Hormones were used in every patient. Median follow-up was 36 months. Risk groups were low (either Stage < or =T2a, +/- Gleason score < or =6, +/- Prostate-Specific Antigen [PSA] level < or =10 ng/mL); intermediate (either Stage T2b,c, +/- Gleason score 7, +/- PSA 10-20 ng/mL); and high (either Stage T3, +/- Gleason score 8-10, +/- PSA >20 ng/mL). RESULTS: At 3 years, Radiotherapy Oncology Group (RTOG) Grade 3 and 4 genito-urinary toxicity was 4% and 1.4%; RTOG Grade 3 and 4 gastro-intestinal toxicity was 2.6% and 0%, respectively. Erectile preservation was 61%. Overall survival was 93% (154 of 165) and cause-specific survival was 98% (162 of 165). At 3 years, disease free survival (DFS) was 93% (153 of 165). DFS for low-, intermediate-, and high-risk groups was 100%, 97%, and 81%, respectively (chi(2) (2) = 16.02, p = 0.0003). The nadir plus 2 ng/mL definition (chi(2) (2) = 14.49, p = 0.0007) best predicted clinical failure, having the lowest false-positive rate (3 of 165). The nadir plus 2 ng/mL PSA-progression-free survival (PSA-PFS) rate was 100%, 95%, and 87% for the low-, intermediate, and high-risk groups, respectively. Overall ASTRO PSA-PFS rate was 88%. CONCLUSIONS: Pulsed dose rate brachytherapy plus EBRT is effective in treating localized prostate cancer, with acceptable toxicity. However, a median 5-year PSA-PFS follow-up is required before providing a solid recommendation. This preliminary information supports continued use.
PURPOSE: To present preliminary outcomes of pulsed dose rate brachytherapy (PDR-BT), external beam radiotherapy (EBRT), and hormonal manipulation, for prostate cancer. PATIENTS AND METHODS: Between December 1999 and January 2005, 165 consecutive patients with Stage T1-T3, N0, M0 prostate cancer were treated. Hormones were used in every patient. Median follow-up was 36 months. Risk groups were low (either Stage < or =T2a, +/- Gleason score < or =6, +/- Prostate-Specific Antigen [PSA] level < or =10 ng/mL); intermediate (either Stage T2b,c, +/- Gleason score 7, +/- PSA 10-20 ng/mL); and high (either Stage T3, +/- Gleason score 8-10, +/- PSA >20 ng/mL). RESULTS: At 3 years, Radiotherapy Oncology Group (RTOG) Grade 3 and 4 genito-urinary toxicity was 4% and 1.4%; RTOG Grade 3 and 4 gastro-intestinal toxicity was 2.6% and 0%, respectively. Erectile preservation was 61%. Overall survival was 93% (154 of 165) and cause-specific survival was 98% (162 of 165). At 3 years, disease free survival (DFS) was 93% (153 of 165). DFS for low-, intermediate-, and high-risk groups was 100%, 97%, and 81%, respectively (chi(2) (2) = 16.02, p = 0.0003). The nadir plus 2 ng/mL definition (chi(2) (2) = 14.49, p = 0.0007) best predicted clinical failure, having the lowest false-positive rate (3 of 165). The nadir plus 2 ng/mL PSA-progression-free survival (PSA-PFS) rate was 100%, 95%, and 87% for the low-, intermediate, and high-risk groups, respectively. Overall ASTRO PSA-PFS rate was 88%. CONCLUSIONS: Pulsed dose rate brachytherapy plus EBRT is effective in treating localized prostate cancer, with acceptable toxicity. However, a median 5-year PSA-PFS follow-up is required before providing a solid recommendation. This preliminary information supports continued use.
Authors: Brian V Balgobind; Kees Koedooder; Diego Ordoñez Zúñiga; Raquel Dávila Fajardo; Coen R N Rasch; Bradley R Pieters Journal: Br J Radiol Date: 2015-08-20 Impact factor: 3.039
Authors: Nicholas G Zaorsky; Brian J Davis; Paul L Nguyen; Timothy N Showalter; Peter J Hoskin; Yasuo Yoshioka; Gerard C Morton; Eric M Horwitz Journal: Nat Rev Urol Date: 2017-06-30 Impact factor: 14.432