Low dose rate brachytherapy (LDR-BT) as monotherapy for early stage prostate cancer in Italy: Practice and outcome analysis in a series of 2237 patients from 11 institutions
| Autor: | Giovanni Silvano, Luigi Santoro, Valentina Cerboneschi, Grazia Lazzari, Laura Bandera, Emilio Gastaldi, Tiziana Palloni, Paola Mangili, Roberto Santini, Vincenzo Fusco, Mauro Paoluzzi, Roberto Orecchia, Riccardo Santoni, Nunzia Ciscognetti, Renato Chiarlone, Andrea Vavassori, Umberto Ricardi, Stefania Clemente, Salvatore Mussari, Giuseppe Schinaia, Francesco Ziglio, Francesco Pio Mangiacotti, Beniamino La Face, Alessia Guarneri, F. Barbera, Barbara Alicja Jereczek-Fossa, C. Divan, Valentina Ravaglia, C. Chiumento, Federica Cattani, Maria Alessandra Mirri, Marco Stefanacci, Nadia Di Muzio, Michela Buglione, R. Spoto, Andrea Losa, Francesca Romana Giglioli, Giovanni Fellin, B. Ghedi, Luciano Nava, Stefano Maria Magrini, Marco Martini, Marcello Mignogna |
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| Přispěvatelé: | Fellin, G, Mirri, Ma, Santoro, L, Jereczek-Fossa, Ba, Divan, C, Mussari, S, Ziglio, F, La Face, B, Barbera, F, Buglione, M, Bandera, L, Ghedi, B, Di Muzio, N, Losa, A, Mangili, P, Nava, L, Chiarlone, R, Ciscognetti, N, Gastaldi, E, Cattani, F, Spoto, R, Vavassori, A, Giglioli, Fr, Guarneri, A, Cerboneschi, V, Mignogna, M, Paoluzzi, M, Ravaglia, V, Chiumento, C, Clemente, S, Fusco, V, Santini, R, Stefanacci, M, Mangiacotti, Fp, Martini, M, Palloni, T, Schinaia, G, Lazzari, G, Silvano, G, Magrini, S, Ricardi, U, Santoni, R, Orecchia, R. |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Oncology
Male medicine.medical_treatment Brachytherapy Outcome analysis Kaplan-Meier Estimate Practice Patterns 030218 nuclear medicine & medical imaging Prostate cancer 0302 clinical medicine Nuclear Medicine and Imaging 80 and over Practice Patterns Physicians' Ultrasonography Aged 80 and over Radiation Full Paper Interventional Adult Aged Dose-Response Relationship Radiation Humans Italy Middle Aged Neoplasm Recurrence Local Prostate-Specific Antigen Prostatic Neoplasms Radiotherapy Dosage Treatment Outcome Ultrasonography Interventional Radiology Nuclear Medicine and Imaging General Medicine Low-Dose Rate Brachytherapy Prostate-specific antigen Local 030220 oncology & carcinogenesis Meta-analysis Radiology medicine.medical_specialty Dose-Response Relationship 03 medical and health sciences Internal medicine medicine Radiology Nuclear Medicine and imaging Series (stratigraphy) Physicians' Proportional hazards model business.industry medicine.disease Surgery Neoplasm Recurrence Aged 80 and over Physicians business |
| Popis: | Low-dose-rate brachytherapy (LDR-BT) in localized prostate cancer is available since 15 years in Italy. We realized the first national multicentre and multidisciplinary data collection to evaluate LDR-BT practice, given as monotherapy, and outcome in terms of biochemical failure.Between May 1998 and December 2011, 2237 patients with early-stage prostate cancer from 11 Italian community and academic hospitals were treated with iodine-125 ((125)I) or palladium-103 LDR-BT as monotherapy and followed up for at least 2 years. (125)I seeds were implanted in 97.7% of the patients: the mean dose received by 90% of target volume was 145 Gy; the mean target volume receiving 100% of prescribed dose (V100) was 91.1%. Biochemical failure-free survival (BFFS), disease-specific survival (DSS) and overall survival (OS) were estimated using Kaplan-Meier method. Log-rank test and multivariable Cox regression were used to evaluate the relationship of covariates with outcomes.Median follow-up time was 65 months. 5- and 7-year DSS, OS and BFFS were 99 and 98%, 94 and 89%, and 92 and 88%, respectively. At multivariate analysis, the National Comprehensive Cancer Network score (p 0.0001) and V100 (p = 0.09) were correlated with BFFS, with V100 effect significantly different between patients at low risk and those at intermediate/high risk (p = 0.04). Short follow-up and lack of toxicity data represent the main limitations for a global evaluation of LDR-BT.This first multicentre Italian report confirms LDR-BT as an excellent curative modality for low-/intermediate-risk prostate cancer.Multidisciplinary teams may help to select adequately patients to be treated with brachytherapy, with a direct impact on the implant quality and, possibly, on outcome. |
| Databáze: | OpenAIRE |
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