A single institution analysis of low-dose-rate brachytherapy: 5-year reported survival and late toxicity outcomes.

2018-04

Chao, Michael

Spencer, Sandra

Guerrieri, Mario

Ding, Wei

Goharian, Mehran

Ho, Huong

Ng, Michael

Healey, Danielle

Tan, Alwin

Cham, Chee

Joon, Daryl Lim

Lawrentschuk, Nathan

Travis, Douglas

Sengupta, Shomik

Chan, Yee

Troy, Andrew

Pham, Trung

Clarke, David

Liodakis, Peter

Bolton, Damien M

brachytherapy

prostatic neoplasms

transurethral resection of prostate

Journal Article

0000-0001-8553-5618

0000-0002-5145-6783

10.5114/jcb.2018.75600

To report the 5-year biochemical relapse-free survival (BRFS), overall survival (OS), and long-term toxicity outcomes of patients treated with low-dose-rate (LDR) brachytherapy as monotherapy for low- to intermediate-risk prostate cancer. Between 2004 and 2011, 371 patients were treated with LDR brachytherapy as monotherapy. Of these, 102 patients (27%) underwent transurethral resection of the prostate (TURP) prior to implantation. Follow-up was performed every 3 months for 12 months, then every 6 months over 4 years and included prostate specific antigen evaluation. The biochemical relapse-free survival (BRFS) was defined according to the Phoenix criteria. Acute and late toxicities were documented using the Common Terminology Criteria for Adverse Events version 4.0. The BRFS and OS estimates were calculated using Kaplan-Meier plots. Univariate and multivariate analyses were performed to evaluate outcomes by pre-treatment clinical prognostic factors and radiation dosimetry. The median follow-up of all patients was 5.45 years. The 5-year BRFS and OS rates were 95% and 96%, respectively. The BRFS rates for patients with Gleason score (GS) > 7 and GS ≤ 6 were 96% and 91% respectively (p = 0.06). On univariate analysis, T1 and T2 staging, risk-group classification, and prostate volumes had no impact on survival at 5 years (p > 0.1). Late grade 2 and 3 genitourinary (GU) toxicities were observed in 10% and 5% of patients respectively. Additionally, patients with prior TURP had a greater incidence of late grade 2 or 3 urinary retention (p = 0.001). There were 14 deaths in total; however, none were attributed to prostate cancer. LDR brachytherapy is an effective treatment option in low- to intermediate-risk prostate cancer patients. We observed low biochemical relapse rates and minimal GU toxicities several years after treatment in patients with or without TURP. However, a small risk of urinary retention was observed in some patients.

link

Journal of contemporary brachytherapy 2018; 10(2): 155-161

Journal of contemporary brachytherapy

1689-832X