PURPOSE: To report outcomes for 1,111 men treated with iodine-125 brachytherapy (BT) at a single institution. METHODS AND MATERIALS: A total of 1,111 men (median age, 63) were treated with iodine-125 prostate BT for low- or intermediate-risk prostate cancer between March 1999 and November 2008. Median prostate-specific antigen (PSA) level was 5.4 ng/ml (range, 0.9-26.1). T stage was T1c in 66% and T2 in 34% of patients. Gleason score was 6 in 90.1% and 7 or 8 in 9.9% of patients. Neoadjuvant hormonal therapy (2-6 months course) was used in 10.1% of patients and combined external radiotherapy (45 Gy) with BT (110 Gy) in 4.1% (n = 46) of patients. Univariate and multivariate Cox proportional hazards were used to determine predictors of failure. RESULTS: Median follow-up was 42 months (range, 6-114), but for biochemical freedom from relapse, a minimum PSA test follow-up of 30 months was required (median 54; n = 776). There were 27 failures, yielding an actuarial 7-year disease-free survival rate of 95.2% (96 at risk beyond 84 months). All failures underwent repeat 12-core transrectal ultrasound -guided biopsies, confirming 8 local failures. On multivariate analysis, Gleason score was the only independent predictor of failure (p = 0.001; hazard ratio, 4.8 (1.9-12.4). Median International Prostate Symptom score from 12 to 108 months ranged between 3 and 9. Of the men reporting baseline potency, 82.8% retained satisfactory erectile function beyond 5 years. CONCLUSION: Iodine-125 prostate BT is a highly effective treatment option for favorable- and intermediate-risk prostate cancer and is associated with maintenance of good urinary and erectile functions.
PURPOSE: To report outcomes for 1,111 men treated with iodine-125 brachytherapy (BT) at a single institution. METHODS AND MATERIALS: A total of 1,111 men (median age, 63) were treated with iodine-125 prostate BT for low- or intermediate-risk prostate cancer between March 1999 and November 2008. Median prostate-specific antigen (PSA) level was 5.4 ng/ml (range, 0.9-26.1). T stage was T1c in 66% and T2 in 34% of patients. Gleason score was 6 in 90.1% and 7 or 8 in 9.9% of patients. Neoadjuvant hormonal therapy (2-6 months course) was used in 10.1% of patients and combined external radiotherapy (45 Gy) with BT (110 Gy) in 4.1% (n = 46) of patients. Univariate and multivariate Cox proportional hazards were used to determine predictors of failure. RESULTS: Median follow-up was 42 months (range, 6-114), but for biochemical freedom from relapse, a minimum PSA test follow-up of 30 months was required (median 54; n = 776). There were 27 failures, yielding an actuarial 7-year disease-free survival rate of 95.2% (96 at risk beyond 84 months). All failures underwent repeat 12-core transrectal ultrasound -guided biopsies, confirming 8 local failures. On multivariate analysis, Gleason score was the only independent predictor of failure (p = 0.001; hazard ratio, 4.8 (1.9-12.4). Median International Prostate Symptom score from 12 to 108 months ranged between 3 and 9. Of the men reporting baseline potency, 82.8% retained satisfactory erectile function beyond 5 years. CONCLUSION:Iodine-125 prostate BT is a highly effective treatment option for favorable- and intermediate-risk prostate cancer and is associated with maintenance of good urinary and erectile functions.
Authors: Mira Keyes; Juanita Crook; W James Morris; Gerard Morton; Tom Pickles; Nawaid Usmani; Eric Vigneault Journal: Can Urol Assoc J Date: 2013 Jan-Feb Impact factor: 1.862
Authors: Thomas J Pugh; Usama Mahmood; David A Swanson; Mark F Munsell; Run Wang; Rajat J Kudchadker; Teresa L Bruno; Steven J Frank Journal: Brachytherapy Date: 2014-09-23 Impact factor: 2.362
Authors: Mira Keyes; Juanita Crook; Gerard Morton; Eric Vigneault; Nawaid Usmani; W James Morris Journal: Can Fam Physician Date: 2013-12 Impact factor: 3.275
Authors: Murray D Krahn; Karen E Bremner; Shabbir M H Alibhai; Andy Ni; George Tomlinson; Audrey Laporte; Gary Naglie Journal: Qual Life Res Date: 2013-04-06 Impact factor: 4.147
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