Prognostic Significance of 5-Year PSA Value for Predicting Prostate Cancer Recurrence After Brachytherapy Alone and Combined With Hormonal Therapy and/or External Beam Radiotherapy

10-Year Experience With I-125 Prostate Brachytherapy at the Princess Margaret Hospital: Results for 1,100 Patients

“…Only 10% of patients at 5 years have PSA level of >0.2 ng/ml, and 2/3 of these patients are still showing a decreasing trend. This is very similar to observations in the report by Stock et al (18) where only 10.9% of 742 patients had a PSA level of >0.2 ng/ml at 5 years. The 10-year freedom from BF was 98% for a 5-year PSA level of <0.2 and 81% for a PSA level of >0.2 ng/ml.…”

Brachytherapy or Conformal External Radiotherapy for Prostate Cancer: A Single-Institution Matched-Pair Analysis

“…It has been argued that such lower PSA values are to be expected after BT because the very high radiation dose delivered by BT causes metabolic atrophy, which is not the case with conventional doses of EBRT; therefore, comparisons of PSA nadirs may not accurately reveal future trends in bNED rates (15). However, there is also substantial evidence showing that the PSA nadir is correlated with the relapse rate, implying that further relapses may be seen during longer follow-up in our EBRT group but not in the BT group (16,17). The slower PSA doubling time in EBRT patients likely reflects occult local persistence/ relapse caused by relative underdosage with EBRT (18).…”

Clinical Significance of Neoadjuvant Combined Androgen Blockade for More Than Six Months in Patients with Localized Prostate Cancer Treated with Prostate Brachytherapy

“…Prostate BT with a permanent I-125 implant has been established as an effective treatment for localized prostate cancer because of the minimal invasiveness and good outcomes. Recently, with increasing doses delivered to the prostate and its effective combination with external beam radiation therapy (EBRT) or hormone therapy, the outcome of prostate BT has improved in patients with low-, intermediate- and even high-risk localized prostate cancer [3,4,5,6,7,8]. Concerning the combination of hormone therapy with EBRT, the positive impacts of hormone therapy for intermediate- and high-risk prostate cancer have been established in several prospective, randomized, clinical trials [9,10].…”