High rate of local control and cure at 10 years after treatment of prostate cancer with external beam radiotherapy and high-dose-rate brachytherapy: a single centre experience

Autor:	Marie Hjälm-Eriksson, Hemming Johansson, Enrique Castellanos, Göran Lundell, Yvonne Brandberg, Bo Lennernäs, Sten Nilsson, Anders Ullén
Rok vydání:	2021
Předmět:	Male medicine.medical_specialty medicine.medical_treatment Brachytherapy Urology Prostate cancer Prostate medicine Humans Radiology Nuclear Medicine and imaging Cumulative incidence External beam radiotherapy Aged Retrospective Studies business.industry Prostatic Neoplasms Radiotherapy Dosage Hematology General Medicine Prostate-Specific Antigen medicine.disease High-Dose Rate Brachytherapy Radiation therapy medicine.anatomical_structure Oncology Cohort Neoplasm Recurrence Local business
Zdroj:	Acta Oncologica. 60:1301-1307
ISSN:	1651-226X 0284-186X
DOI:	10.1080/0284186x.2021.1953706
Popis:	BACKGROUND AND PURPOSE To analyse the cumulative incidence of any failure (AF), prostate cancer-specific failure (PCSF), any death (AD), prostate cancer-specific death (PCSD), and local control in 2387 men with prostate cancer (PC), consecutively treated with combined high-dose-rate brachytherapy (HDRBT) and external beam radiotherapy (EBRT) from 1998 to 2010. MATERIAL AND METHODS A retrospective, single-institution study of men with localised PC. The mean age was 66 years and 54.7% had high-risk PC according to the Cambridge prognostic group (CPG) classification. The treatment was delivered as EBRT (2 Gy × 25) and HDRBT (10 Gy × 2) with combined androgen blockade (CAB). The median follow-up was 10.2 years. RESULTS The cumulative incidence of PCSD at 10 years was 5% [CI 95% 0.04-0.06]. The 10 years PCSD per risk group were: low (L) 0.4%, intermediate favourable (IF) 1%, intermediate unfavourable (IU) 4.3%, high-risk favourable (HF) 5.8%, and high-risk unfavourable (HU) 13.9%. The PCSF rate at 10 years was 16.5% [CI 95% 0.15-0.18]. The PCSF per risk group at 10 years were: L 2.5%, IF 5.5%, IU 15.9%, HF 15.6%, and HU 38.99%. PCSF occurred in 399 men, of whom 15% were found to have local failure. The estimated frequency of local failure in the entire cohort was 1.2%. CONCLUSIONS HDRBT combined with EBRT is an effective treatment with long-term overall survival and excellent local control for patients with PC. The low rate of local recurrence among men with relapse suggests that these patients were micro metastasised at time of treatment, which calls for improved methods to detect disseminated disease.
Databáze:	OpenAIRE
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