Treatment of low-risk prostate cancer: a retrospective study with 477 patients comparing external beam radiotherapy and I-125 seeds brachytherapy in terms of biochemical control and late side effects

Moll, Matthias; Paschen, Christopher; Zaharie, Alexandru; Berndl, Florian; Goldner, Gregor

doi:10.1007/s00066-020-01657-1

Cited by 10 publications

(8 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regarding late side effects, we observed reduced genitourinary side effects and increased gastrointestinal side effects for EBRT in comparison to seeds. This resembles the results in our low-risk collective [3]. For maximum side effects, we noticed a significant increase for late genitourinary side effects in patients treated with 78 Gy compared to 74 Gy.…”

Section: Discussionsupporting

confidence: 87%

“…Localized primary prostate cancer can be treated via external beam radiotherapy (EBRT) or permanent interstitial seed brachytherapy (BT). Both of these treatment modalities achieve excellent tumor control rates [1][2][3]. The recommendations and guidelines consider these modalities as equivalent especially for patients with low-risk prostate cancer [1,2].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of EBRT and I-125 seed brachytherapy concerning outcome in intermediate-risk prostate cancer

et al. 2021

Self Cite

View full text Add to dashboard Cite

Purpose This study’s objective was the comparison of external beam radiotherapy (EBRT) and I‑125 seed brachytherapy regarding clinical outcome and development of side effects. Patients and methods In all, 462 localized intermediate-risk prostate cancer patients treated between 2000 and 2019 at our department using either I‑125 seed brachytherapy or EBRT with a dose of 74 or 78 Gy were included: 297 patients were treated with EBRT and 165 with seeds. Biochemical no evidence of disease (bNED) rates according to Phoenix definition as well as late gastrointestinal and urogenital side effects (EORTC/RTOG) were assessed. Results Patients were followed up yearly with a median follow-up of 54 (3–192) months. Observed bNED rates for 74 Gy, 78 Gy and seeds were 87, 92, and 88% after 5 years and 71, 85, and 76% after 9 years, respectively. No significant differences were found comparing seeds with 74 Gy (p = 0.81) and 78 Gy (p = 0.19), as well as between 74 and 78 Gy (p = 0.32). Concerning gastrointestinal side effects, EBRT showed significantly higher rates of RTOG grade ≥ 2 toxicity compared to seeds, but at no point of the follow-up more than 10% of all patients. However, genitourinary side effects were significantly more prevalent in patients treated with seeds, with 33% RTOG grade ≥ 2 toxicity 12 months after treatment. Nevertheless, both types of side effects decreased over time. Conclusion Favorable intermediate-risk prostate cancer patients can be treated either by external beam radiotherapy (74/78 Gy) or permanent interstitial seed brachytherapy.

show abstract

Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Comparison of EBRT and I-125 seed brachytherapy concerning outcome in intermediate-risk prostate cancer

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…Therefore, we replaced it with HDG10.01 B (2,134 points for patients >74 years old) and HDG10.01 C (1,381 points for patients ≤74 years old) for prostate cancer. As the median age of patients is <75 years ( 13 – 15 ), we decided to use HDG10.01 C for further calculations.…”

Section: Resultsmentioning

confidence: 99%

“…Advantages of surgery and brachytherapy are the one-time intervention, whereas EBRT, even in moderately hypofractionated schedules, takes place over 3–4 weeks, though one-time stereotactic treatments are being evaluated ( 23 ). Regarding side effects, EBRT leads to more gastrointestinal side effects but less urinary incontinence and erectile dysfunction within the first 5 years compared to surgery ( 24 ), whereas brachytherapy leads to more genitourinary, but less gastrointestinal, toxicity compared to EBRT ( 13 ). These facts have to be evaluated, as treatment costs for all modalities in low- and intermediate-risk prostate cancer are well below 10,000 € per treatment, even at the University Hospital Vienna, and side effects may persist for up to at least 5 years ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison of treatment costs for primary localized prostate cancer in Austria and Vienna: an economic analysis

Moll

Goldner

2023

Front. Public Health

Self Cite

View full text Add to dashboard Cite

BackgroundProstate cancer is the most common cancer in men. Several efficient treatments are available for primary prostate cancer, but an economic comparison of these modalities has not been done in Austria.Objective and settingThe current study provides an economic comparison of radiotherapy and surgery for prostate cancer in Vienna and Austria.MethodsWe analyzed the catalog of medical services of the Austrian Federal Ministry of Social Affairs, Health, Care and Consumer Protection and present the treatment costs for the public health sector with an LKF-point value and monetary value in 2022.ResultsExternal beam radiotherapy, especially ultrahypofractionated, is the least costly treatment modality for low-risk prostate cancer, with costs of 2,492 € per treatment. For intermediate-risk prostate cancer, differences between moderate hypofractionation and brachytherapy are small, with costs of 4,638–5,140 €. In a high-risk setting, differences between radical prostatectomy and radiotherapy with androgen deprivation therapy are small (7,087 € vs. 7474.06 €).ConclusionFrom a purely financial point of view, treatment of low- and intermediate-risk prostate cancer in Vienna and Austria should consist of radiotherapy as long as the current catalog of services is up to date. For high-risk prostate cancer, no major difference was found.

show abstract

“…Regarding toxicity, we found that the association of EBRT and seeds supposes a greater risk of urological (from 16.9% to 26.1%) and rectal complications (from 2.5% to 10.1%). Generally, the use of external RT increases the risk of digestive toxicity [ 31 ]. Even so, urological G3 toxicity occurs only in 5.8% and rectal G3 toxicity in one case, fewer than the data published in the ASCENDE-RT study (only 6% of toxicity was persistent) [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Long-term results with custom-linked iodine-125 seeds and real-time brachytherapy in low- and intermediate-risk prostate cancer

Guinot¹,

Casanova²,

González-Pérez³

et al. 2022

jcb

View full text Add to dashboard Cite

Purpose Brachytherapy (BT) with iodine-125 ( 125 I) seeds is effective in low- and intermediate-risk prostate carcinoma, with fewer side effects compared to other techniques, but relapses increase in long-term. In the present paper, 10-year biochemical relapse-free survival (BRFS) results are presented. Material and methods Between 2007 and 2016, 706 patients were treated with real-time technique using Bard-ProLink™ system. 145 Gy was administered to the prostate with exclusive BT and 108 Gy after 46 Gy of external radiotherapy (EBRT). Androgen deprivation therapy was applied in 19.3% of patients. Results Median follow-up was 96 months (range, 24-163 months). BRFS at 5 and 10 years was 95% and 91.1%, respectively. For 480 low-risk cases, BRFS at 5 and 10 years was 95.7% and 92.7%, and for 226 intermediate-risk cases, it was 92.7% and 88%, respectively ( p < 0.05). With combined treatment of EBRT + BT, 133 cases (59%) of intermediate-risk were treated without differences with exclusive BT. Gleason score 4 + 3 cases dropped to 72.8% at 10 years ( p < 0.001), with androgen deprivation therapy (ADT) to 90.9% and without ADT to 66.8%; it was worse if patients had exclusive BT. 10-year BRFS for T1c was 95% compared to 84% for T2 ( p < 0.001). Initial prostate specific antigen (PSA) > or < 10 showed no differences. With > 50% biopsy cores positive, it fell to 80% at 10 years ( p < 0.001). In 154 patients up to 60 years of age, 10-year BRFS was 97.6%. Urinary complications appeared in 16.9% of cases in exclusive BT vs. 26.1% in EBRT + BT. Grade 2+ urinary late complications were observed in 19.1% and grade 3+ in 5.8% of patients. Rectal toxicity was 4% (2.5% in BT alone and 10.1% in RT + BT), while G3+ was seen in 0.1%. Conclusions Real-time BT with custom-linked 125 I seeds is a very effective long-term treatment in low- and intermediate-risk prostate carcinoma. With Gleason score 4 + 3 or > 50% biopsy cores positive, we recommend combined treatment with additional ADT for 6 months.

show abstract

Treatment of low-risk prostate cancer: a retrospective study with 477 patients comparing external beam radiotherapy and I-125 seeds brachytherapy in terms of biochemical control and late side effects

Cited by 10 publications

References 30 publications

Comparison of EBRT and I-125 seed brachytherapy concerning outcome in intermediate-risk prostate cancer

Comparison of EBRT and I-125 seed brachytherapy concerning outcome in intermediate-risk prostate cancer

Comparison of treatment costs for primary localized prostate cancer in Austria and Vienna: an economic analysis

Long-term results with custom-linked iodine-125 seeds and real-time brachytherapy in low- and intermediate-risk prostate cancer

Contact Info

Product

Resources

About