Prostate cancer-specific death in brachytherapy treated high-risk patients stratified by pre-treatment PSA.

Autor: Merrick GS; Schiffler Cancer Center and Wheeling Jesuit University, Wheeling, WV.; Wheeling Hospital, Department of Urology, Wheeling, WV., Galbreath RW; Schiffler Cancer Center and Wheeling Jesuit University, Wheeling, WV.; Ohio University Eastern, St. Clairsville, OH., Butler WM; Schiffler Cancer Center and Wheeling Jesuit University, Wheeling, WV., Fiano R; Schiffler Cancer Center and Wheeling Jesuit University, Wheeling, WV., Adamovich E; Wheeling Hospital, Department of Pathology, Wheeling, WV, USA.
Jazyk: angličtina
Zdroj: Journal of contemporary brachytherapy [J Contemp Brachytherapy] 2017 Aug; Vol. 9 (4), pp. 297-303. Date of Electronic Publication: 2017 Aug 30.
DOI: 10.5114/jcb.2017.69588
Abstrakt: Purpose: To evaluate prostate-cancer specific mortality (PCSM) in a cohort of high-risk patients treated with a permanent prostate brachytherapy approach, stratified by pre-treatment PSA.
Material and Methods: 448 high-risk patients (NCCN criteria) underwent permanent prostate brachytherapy. High risk patients were stratified by pre-treatment PSA (≤ 10.0, 10.1-20, and > 20 ng/ml). Biochemical failure (BF), prostate cancer-specific mortality (PCSM), distant failure (DM), and overall mortality (OM) were assessed as a function of prognostic group. Multiple clinical, treatment, and dosimetric parameters were evaluated for impact on outcome.
Results: The 10-year OM, BF, and PCSM for the entire cohort were 28.5%, 13.3%, and 4.9%, respectively. At 10 years, PCSM was 2.5%, 10.7%, and 4.5% in the PSA ≤ 10, 10.1-20, and > 20 ng/ml groups, respectively. No statistically significant differences in BF or overall survival (OS) were noted when stratified by pre-treatment PSA. DF was the most common in the 10.1-20 ng/ml cohort (8.6% at 10 years). In multivariate analysis, PCSM was most closely related to percent positive biopsies ( p = 0.001) and tobacco ( p = 0.042).
Conclusions: High-risk prostate cancer treated with permanent prostate brachytherapy and supplemental external beam radiotherapy resulted in excellent long-term biochemical control and PCSM. Overall, PCSM was low in all cohorts but highest in the intermediate PSA group (10.1-20 ng/ml).
Databáze: MEDLINE
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