Brachytherapy monotherapy may be sufficient for a subset of patients with unfavorable intermediate risk prostate cancer

King, Martin T.; Chen, Ming‐Hui; Moran, Brian; Braccioforte, Michelle H.; Buzurović, Ivan; Muralidhar, Vinayak; Yang, David D.; Mouw, Kent W.; Devlin, Phillip M.; D’Amico, Anthony V.; Nguyen, Paul L.; Orio, Peter F.

doi:10.1016/j.urolonc.2017.11.022

Cited by 7 publications

(5 citation statements)

References 18 publications

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“…We found no apparent benefit of adding ADT or EBRT to LDR‐BT for IR patients overall, consistent with previous results 14,15 . However, we found significant differences in outcomes when LDR‐BT monotherapy was compared to other treatments in patients with two to three unfavorable IRFs after patients had been stratified according to the number of unfavorable IRFs (Table 3).…”

Section: Discussionsupporting

confidence: 89%

“…In a retrospective work, Yang et al 14 reported that the addition of EBRT to BT (LDR‐BT or high‐dose‐rate BT) did not improve prostate cancer‐specific mortality in almost 4500 patients with NCCN favorable‐ or unfavorable‐IR prostate cancer. Recently, King et al 15 reported that supplemental therapies (ADT, EBRT, or both) did not improve prostate cancer‐specific mortality (compared to LDR‐BT alone) in almost 4000 IR prostate cancer patients.…”

Section: Discussionmentioning

confidence: 99%

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Clinical significance of unfavorable findings in intermediate‐risk prostate cancer patients for predicting treatment outcomes after contemporary, dose‐escalated multimodal radiotherapy

et al. 2021

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Purpose Few studies have documented the long‐term oncological outcomes of favorable and unfavorable intermediate‐risk (IR) prostate cancer patients treated via contemporary high‐dose irradiation. We analyzed the ultimate clinical outcomes of such patients using the current risk sub‐stratification schema. Patients and Methods We included 693 patients with localized IR prostate cancer treated via low‐dose‐rate brachytherapy (LDR‐BT) with or without external beam radiation (EBRT) and with or without androgen‐deprivation therapy (ADT) in a single institution. Treatment outcomes (biochemical recurrence‐free survival [BCRFS] and clinical progression‐free survival [CPFS]) were compared according to the numbers of unfavorable findings. Results Out of the 693 IR patients, 292 (42.1%) exhibited favorable disease; the remaining 401 (57.9%) exhibited unfavorable disease. Compared with favorable IR status, unfavorable IR status was associated with shorter BCRFS and CPFS (p < 0.001 and p < 0.001, respectively). Patients with two to three unfavorable factors experienced the worst oncological outcomes (p < 0.001 and p < 0.001). Although patients with one or no unfavorable factors responded similarly to LDR‐BT monotherapy, this treatment modality was insufficient for preventing biochemical and clinical progression in patients with multiple unfavorable findings. Conclusion Long‐term treatment outcomes indicate that patients with IR disease scheduled for LDR‐BT should undergo multimodal irradiation if they exhibit two or more unfavorable factors at diagnosis.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Clinical significance of unfavorable findings in intermediate‐risk prostate cancer patients for predicting treatment outcomes after contemporary, dose‐escalated multimodal radiotherapy

et al. 2021

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“…PSA suppression therapy had a lower effect on overall survival in that group. Another report by Martin et al showed that brachytherapy alone may be effective in a specific subgroup of patients with intermediate PCa [33]. Brachytherapy alone potentially delivers a lower radiation dose to the urethra and rectum than brachytherapy combined with external beam radiation therapy [34].…”

Section: Tri-modality Therapy For Locally Advanced Pca and Adverse Ev...mentioning

confidence: 99%

Clinical Efficacy and Openness to New Challenges of Low Dose Rate Brachytherapy for Prostate Cancer

Kato,

Higashi,

Sugino

et al. 2023

Current Oncology

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Over a century ago, low-dose-rate (LDR) brachytherapy was introduced to treat prostate cancer (PCa). Since then, it has been widely applied worldwide, including in East Asia. LDR brachytherapy has been performed in 88 institutes in Japan. Beneficial clinical outcomes of LDR brachytherapy for intermediate-to-high-risk PCa have been demonstrated in large clinical trials. These clinical outcomes were achieved through advances in methods, such as urological precise needle puncture and seed placement, and the quantitative decision making regarding radiological parameters by radiation oncologists. The combined use of LDR brachytherapy with other therapeutic modalities, such as external beam radiation and androgen deprivation therapy, for the clinical risk classification of PCa has led to better anticancer treatment efficacy. In this study, we summarized basic LDR brachytherapy findings that should remain unchanged and be passed down in urology departments. We also discussed the applications of LDR brachytherapy for PCa in various clinical settings, including focal and salvage therapies. In addition, we highlighted technologies associated with brachytherapy that are under development.

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“…Another report by Martin et al showed that brachytherapy alone may be effective in a specific subgroup of patients with intermediate PCa. (23) Brachytherapy alone potentially delivers a lower radiation dose to the urethra and rectum than brachytherapy combined with external beam radiation therapy. (24) In clinical practice, patients with PCa who demonstrated a large prostate volume, showed PSA levels of >10, and were classified as the intermediate-risk group demonstrated good responses to brachytherapy alone.…”

Section: Tri-modality Therapy For Locally Advanced Pca and Adverse Ev...mentioning

confidence: 99%

Clinical Efficacy and Openness to New Challenges of Low Dose Rate (LDR) Brachytherapy for Prostate Cancer

Kato,

Higashi,

Sugino

et al. 2023

Preprint

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Over a century ago, low-dose-rate (LDR) brachytherapy was introduced to treat prostate cancer (PCa). Since then, it has been widely applied worldwide, including in East Asia. LDR brachythera-py has been performed in 88 institutes in Japan. Beneficial clinical outcomes of LDR brachytherapy for intermediate-to-high-risk PCa have been demonstrated in large clinical trials. These clinical outcomes were achieved through advances in methods, such as urological precise needle puncture and seed placement, and the quantitative decision-making regarding radiological parameters by radiation oncologists. Combined use of LDR brachytherapy with other therapeutical modalities, such as external beam radiation and androgen deprivation therapy, for clinical risk classification of PCa has led to better anticancer treatment efficacy. In this study, we summarized basic LDR brachytherapy findings that should remain unchanged and be passed down in urology depart-ments. We also discussed the applications of LDR brachytherapy for PCa in various clinical settings, including focal and salvage therapies. In addition, we highlighted technologies associated with brachytherapy that are under development.

show abstract

Brachytherapy monotherapy may be sufficient for a subset of patients with unfavorable intermediate risk prostate cancer

Cited by 7 publications

References 18 publications

Clinical significance of unfavorable findings in intermediate‐risk prostate cancer patients for predicting treatment outcomes after contemporary, dose‐escalated multimodal radiotherapy

Clinical significance of unfavorable findings in intermediate‐risk prostate cancer patients for predicting treatment outcomes after contemporary, dose‐escalated multimodal radiotherapy

Clinical Efficacy and Openness to New Challenges of Low Dose Rate Brachytherapy for Prostate Cancer

Clinical Efficacy and Openness to New Challenges of Low Dose Rate (LDR) Brachytherapy for Prostate Cancer

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