Long-term outcomes of a prospective randomized trial of 131Cs/125I permanent prostate brachytherapy
| Autor: | Manuj Agarwal, Antony Koroulakis, C. DeCesaris, Michelle H. Braccioforte, Brian J. Moran, Neha P. Amin |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
business.industry Urinary system medicine.medical_treatment Brachytherapy Urology 030218 nuclear medicine & medical imaging law.invention 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Oncology Quality of life Randomized controlled trial law Prostate 030220 oncology & carcinogenesis medicine T-stage Radiology Nuclear Medicine and imaging Implant business Prostate brachytherapy |
| Zdroj: | Brachytherapy. 20:38-43 |
| ISSN: | 1538-4721 |
| DOI: | 10.1016/j.brachy.2020.07.005 |
| Popis: | Purpose Iodine-125 (125I) is the most commonly used isotope for prostate brachytherapy (BT). Cesium-131 (131Cs) has a higher dose rate and shorter dose delivery time resulting in decreased duration of acute urinary morbidity. Long-term data suggest excellent oncologic outcomes; it is not known how outcomes compare. A prospective randomized trial comparing the two isotopes was initiated. Materials and Methods Patients with low- or intermediate-risk disease were treated with a BT in a single outpatient facility. Prescription dose was 144 Gy for 125I and 115 Gy for 131Cs. Androgen deprivation or supplemental EBRT was not allowed. The primary study objective was comparison of the mean EPIC Urinary Domain Score. Secondary objective was biochemical relapse-free survival (BRFS) comparison. Time-to-event for all outcomes of interest was measured from implant date. Results One hundred forty men were enrolled; 81.4% were low-risk and 18.6% were intermediate-risk. The median followup was 97 months. Urinary and sexual health-related quality of life did not differ between isotopes at any recorded time point. At 2 months after implantation, bowel health-related quality of life was worse with 125I; however, this difference was lost at subsequent time points. The 9-year BRFS was 87.2% and 84.0% for the 125I and 131Cs group, respectively (p = 0.897). There was no statistically significant difference in BRFS based on initial T stage, PSA, or Gleason score. Conclusions Short- and long-term urinary, sexual, and bowel quality of life, as well as long-term biochemical control were comparable between 125I and 131Cs. This report therefore supports the continued use of 131Cs as an effective and comparable alternative isotope. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|