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Long-term efficacy and urological toxicity of low-dose-rate brachytherapy (LDR-BT) as monotherapy in localized prostate cancer.

Abstract：

PURPOSE:The purpose of this study was to evaluate the incidence of late severe (≥Grade 3) urinary toxicity and the long-term efficacy after low-dose-rate brachytherapy (LDR-BT) in patients with localized prostate cancer (PCa). METHODS AND MATERIALS:During the years 1999-2008, 241 patients with PCa who underwent LDR-BT with I125 and were followed up in Kuopio University Hospital were included to this analysis. The incidence of late severe (Grade 3) urinary toxicity and the long-term efficacy results were analyzed. RESULTS:All D'Amico risk groups were represented, as 58.9%, 35.3%, and 5.8% of the patients were classified as low-, intermediate-, and high-risk patients, respectively. With a median followup of 11.4 years after implantation, the incidence of severe urinary toxicity increased throughout the followup period. The risk of Grade 3 urinary toxicity was highest among patients with higher Gleason scores (p = 0.016) and higher initial urine residual volumes (p = 0.017) and the cumulative incidence of severe urinary toxicity was 10.0%. The crude rate for transurethral prostatic resection was 5.8%. The relapse-free survival, the cause-specific survival, and the overall survival were 79.3%, 95.0%, and 66.4%, respectively. CONCLUSIONS:The treatment was well tolerated as 90% of patients avoided any Grade 3 urinary toxicity. LDR-BT for localized PCa achieved high and durable efficacy. These results support the role of LDR-BT monotherapy as one of the valid primary treatment options for low-risk and favorable intermediate-risk patients.

journal_name

Brachytherapy

journal_title

Brachytherapy

authors

Vuolukka K,Auvinen P,Palmgren JE,Voutilainen T,Aaltomaa S,Kataja V

doi

10.1016/j.brachy.2019.05.005

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

583-588

issue

5

eissn

1538-4721

issn

1873-1449

pii

S1538-4721(19)30083-2

journal_volume

18

pub_type

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