BACKGROUND AND PURPOSE: To report long-term cancer control rates following high dose-rate (HDR) brachytherapy boost for intermediate risk prostate cancer and explore early biochemical predictors of success. MATERIAL AND METHODS: Results of two sequential phase II trials are updated and compared: (1) Single 15 Gy HDR-boost followed by external beam radiotherapy (EBRT) 37.5 Gy/15fractions, (2) Two HDR fractions of 10 Gy followed by EBRT 45 Gy/25fractions. Patients were followed prospectively for clinical and biochemical outcomes. Nadir PSA (nPSA) and PSA at 3-years were analyzed as continuous variables, and ROC analysis was used to identify the optimal cutoff values. Kaplan-Meier bDFS curves were generated and the log-rank test used to compare different groups RESULTS: 183 patients were accrued; 123 to the single fraction trial and 60 to the standard fractionation trial, with a median follow-up of 74 months and 99 months, respectively. The 5-year biochemical relapse-free survival was 97.4% and 92.7%, respectively (p=0.995). Median nPSA was 0.08 ng/ml. Failure to achieve a nPSA <0.4 ng/ml was associated with a significantly higher rate of biochemical relapse (5-year bDFS: 100% vs. 72%; p<0.0001). CONCLUSION: HDR boost with single fraction 15 Gy provides durable long-term biochemical disease-free survival. PSA nadir <0.4 ng/ml is associated with very low risk of biochemical failure.
BACKGROUND AND PURPOSE: To report long-term cancer control rates following high dose-rate (HDR) brachytherapy boost for intermediate risk prostate cancer and explore early biochemical predictors of success. MATERIAL AND METHODS: Results of two sequential phase II trials are updated and compared: (1) Single 15 Gy HDR-boost followed by external beam radiotherapy (EBRT) 37.5 Gy/15fractions, (2) Two HDR fractions of 10 Gy followed by EBRT 45 Gy/25fractions. Patients were followed prospectively for clinical and biochemical outcomes. Nadir PSA (nPSA) and PSA at 3-years were analyzed as continuous variables, and ROC analysis was used to identify the optimal cutoff values. Kaplan-Meier bDFS curves were generated and the log-rank test used to compare different groups RESULTS: 183 patients were accrued; 123 to the single fraction trial and 60 to the standard fractionation trial, with a median follow-up of 74 months and 99 months, respectively. The 5-year biochemical relapse-free survival was 97.4% and 92.7%, respectively (p=0.995). Median nPSA was 0.08 ng/ml. Failure to achieve a nPSA <0.4 ng/ml was associated with a significantly higher rate of biochemical relapse (5-year bDFS: 100% vs. 72%; p<0.0001). CONCLUSION: HDR boost with single fraction 15 Gy provides durable long-term biochemical disease-free survival. PSA nadir <0.4 ng/ml is associated with very low risk of biochemical failure.
Authors: Esther Mayrata; Jose Maria Espinosa; David Büchser; Francisco Casquero; Fernan Suárez; Alba González; Pablo Minguez; Jose Fernando Pérez; Iñigo San Miguel; Jon Cacicedo; Alfonso Gómez-Iturriaga Journal: J Contemp Brachytherapy Date: 2021-02-18
Authors: Juanita M Crook; Chad Tang; Howard Thames; Pierre Blanchard; Jeremiah Sanders; Jay Ciezki; Mira Keyes; W James Morris; Gregory Merrick; Charles Catton; Hamid Raziee; Richard Stock; Frank Sullivan; Mitch Anscher; Jeremy Millar; Steven Frank Journal: Radiother Oncol Date: 2020-04-27 Impact factor: 6.280
Authors: Hong Zhang; Sohyun Kang; Naba Ali; Andrea Baran; Kevin Bylund; David Gentile; Gregory Previte; Ahmad Matloubieh; Alex Gray; Nancy Marou Journal: Adv Radiat Oncol Date: 2020-02-21
Authors: Finbar Slevin; Sree Lakshmi Rodda; Peter Bownes; Louise Murray; David Bottomley; Clare Wilkinson; Ese Adiotomre; Bashar Al-Qaisieh; Emma Dugdale; Oliver Hulson; Joshua Mason; Jonathan Smith; Ann M Henry Journal: Clin Transl Radiat Oncol Date: 2019-10-14
Authors: Tiffany M Morgan; Robert H Press; Patrick K Cutrell; Chao Zhang; Zhengjia Chen; Sara Rahnema; Jaymin Jhaveri; Martin Sanda; John Pattaras; Pretesh Patel; Ashesh B Jani; Peter J Rossi Journal: J Contemp Brachytherapy Date: 2018-06-30
Authors: Tiffany M Morgan; Robert H Press; Patrick K Cutrell; Chao Zhang; Zhengja Chen; Sara Rahnema; Martin Sanda; John Pattaras; Pretesh R Patel; Ashesh B Jani; Peter J Rossi Journal: J Contemp Brachytherapy Date: 2018-12-28
Authors: Hannah M Dahn; Patricia A K Oliver; Stefan Allen; Amanda Cherpak; Alasdair Syme; Nikhilesh Patil; David Bowes Journal: Adv Radiat Oncol Date: 2019-05-21