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Prostate-specific antigen relapse-free survival and side-effects in 734 patients with up to 10 years of follow-up with localized prostate cancer treated by permanent iodine implants.

Abstract：

STUDY TYPE:Therapy (case series) Level of Evidence 4. OBJECTIVE:To report our analysis of the oncological outcome, side-effects and complications after (125)I-brachytherapy, based on 10 years of experience, as low dose-rate (LDR) prostate brachytherapy is an accepted, effective and safe therapy for localized prostate cancer. PATIENTS AND METHODS:Between April 1999 and December 2006, 734 consecutive patients were treated with clinically localized prostate cancer with a follow-up of >or=30 months. No patients received external beam radiotherapy and 43% received hormonal therapy before brachytherapy; this therapy was given for 3-4 months. All patients had LDR prostate brachytherapy administered by one radiation oncologist. Biochemical failure was defined according to the 'Phoenix consensus'. RESULTS:The median follow-up for the 734 patients was 55 months; 26 had a clinical relapse and 11 died from prostate cancer; 20 patients died from other illnesses. The 10-year actuarial biochemical control was 92%, 84% and 65%, respectively (P < 0.001) for the low-, intermediate- and high-risk groups. Multivariate Cox regression analyses identified Gleason score and prostate-specific antigen (PSA) level as independent prognostic factors for biochemical failure. The actuarial biochemical control with Gleason score was 88%, 76% and 67% for patients with a Gleason score of 7, respectively (P < 0.001). The biochemical control was 90%, 80% and 42% for patients with a PSA level of 20 ng/mL, respectively (P < 0.001). No patients reported incontinence after treatment. There was acute urinary retention in 22 (2.9%) patients. Logistic regression showed that the most significant factors correlating with the probability of catheterization were the pretreatment prostate volume and hormonal therapy. CONCLUSIONS:The excellent long-term results and low morbidity, and the many advantages of prostate brachytherapy over other treatments, show that brachytherapy is an effective treatment for clinically organ-confined prostate cancer.

journal_name

BJU Int

journal_title

BJU international

authors

Prada PJ,Juan G,González-Suárez H,Fernández J,Jimenez I,Amón J,Cepeda M

doi

10.1111/j.1464-410X.2009.09096.x

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

32-6

issue

eissn

1464-4096

issn

1464-410X

pii

BJU9096

journal_volume

106

pub_type

杂志文章

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Prostate-specific antigen relapse-free survival and side-effects in 734 patients with up to 10 years of follow-up with localized prostate cancer treated by permanent iodine implants.