Long-term outcome of early stage prostate cancer treated with brachytherapy analysis after a mean follow-up of 7 years

Abstract

PurposeTo investigate the long-term efficacy of 125I brachytherapy in early-stage prostate cancer and to identify correlating factors.MethodsThis study included 117 cases of early stage prostate cancer. The patients ranged in age from 51 to 84 years, with a mean of 73 years. The features of the study population were as follows: the PSA ranged from 0.4 to 47.6 ng/ml (median, 14.7); the Gleason score ranged from 4 to 9 (mean, 6.4); the clinical stage ranged from T1b to T2c; and the positive biopsy rate ranged from 0.08 to 1.0 (mean, 0.45). The mean D90 was 142 Gy and ranged from 106 Gy to 170 Gy. The numbers of low-risk, intermediate-risk and high-risk prostate cancer cases were 22, 29 and 66, respectively. The biochemical no evidence of disease (bNED) rate and overall survival were recorded. Factors that correlated with the outcomes were evaluated.ResultsWith a mean follow up of 84 months, 33 cases had biochemical recurrence, with a bNED rate of 72%. The overall survival rate was 90%, and the cancer-specific survival rate was 97%. The bNED rates in the low-risk, intermediate-risk and high-risk groups were 86%, 79% and 64%, respectively (P = 0.040). The patients with PSA <20 ng/ml, a positive biopsy rate lower than 0.5, and D90 ≥ 140 Gy had lower biochemical recurrence (P = 0.028, 0.006, 0.009, respectively).ConclusionsThe long-term efficacy of 125I brachytherapy in early stage prostate cancer was shown. bNED is related to risk stratification, PSA level, positive biopsy rate and D90.

Five-year effectiveness of low-dose-rate brachytherapy: comparisons with nomogram predictions in patients with non-metastatic prostate cancer presenting significant control of intra- and periprostatic disease

“…Similarly, another large-scale study in the USA determined excellent long-term outcomes with modern LDR brachytherapy in patients at low-, intermediate-, and high-risk [ 26 ]. For LDR brachytherapy as monotherapy, long-term benefits comparable to those described here have been reported across all risk groups in various regions of the world including UK [ 27 ], USA [ 5 , 28 ], France [ 29 ], China [ 30 ], and Japan [ 31 ]. Similarly to the results of this study, superior bPFS rates of brachytherapy compared to those predicted with Kattan nomograms (pre and post-operative) have also been reported for a patient cohort in Israel, which was however smaller and mainly consisted of low-risk patients [ 32 ].…”