Feasibility of brachytherapy as monotherapy for high-volume, low-risk prostate cancer
| Autor: | Laura J West, Dennis R Larock, Mark D. Hurwitz, Powell L. Graham, Arti Parekh, Paul L. Nguyen, Vincent Yeung, Catherine d.P. Duarte |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Brachytherapy Urology Kaplan-Meier Estimate lcsh:RC254-282 Iodine Radioisotopes Androgen deprivation therapy Prostate cancer PSA Failure Proton Therapy Humans Medicine Radiology Nuclear Medicine and imaging Radiation treatment planning Aged Ultrasonography Brachytherapy percent positive cores prognostic factors prostate prostate-specific antigen business.industry Hazard ratio Prostate Prostatic Neoplasms General Medicine Prostate-Specific Antigen medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Confidence interval Surgery Prostate-specific antigen Oncology business Follow-Up Studies |
| Zdroj: | Journal of Cancer Research and Therapeutics, Vol 12, Iss 1, Pp 406-410 (2016) |
| ISSN: | 1998-4138 0973-1482 |
| Popis: | Background: We sought to determine whether patients with high-volume, low-risk prostate cancer are suitable candidates for ultrasound-guided brachytherapy, monotherapy alone, without supplemental external beam radiation. Materials and Methods: The study cohort comprised 200 consecutive patients who received ultrasound.guided monotherapy from November 02, 1998 to March 26, 2010. Real.time intraoperative treatment planning was performed for all patients. 145. Gy with I125 was prescribed to the prostate with no margin. The primary endpoint was time to prostate-specific antigen. (PSA) failure using the phoenix definition. Cox multivariable regression analysis was used to determine the factors significantly associated with time to PSA failure. Results: Median follow-up was 59 months (range 1.2–146.8 months). The median PSA was 5.0 ng/ml. For the overall cohort, both 5- and 8-year PSA failure-free survival was 92.3% (95% confidence interval [95% CI]: 86.5–95.7%). Low-risk patients per the NCCN criteria had 5- and 8-year PSA failure-free survival of 93.6%. On cox multivariable analysis, only baseline PSA (adjusted hazard ratio: 1.29 [95% CI: 1.02–1.65], P = 0.036) was associated with outcome. Among patients with < 33% cores positive, 33–< 50% cores positive, and ≥50% cores positive, the 5-year PSA failure-free survival was 92.3% (95% CI: 85.1–96.1%), 91.0% (95% CI: 68.5–97.6%), and 93.3% (95% CI: 61.2–99.0%), respectively. Conclusions: Our analysis indicates that patients with a high number of cores positive for cancer can be adequately treated with modern brachytherapy as monotherapy and be spared the additional morbidity and cost of supplemental external beam radiation or androgen deprivation therapy. |
| Databáze: | OpenAIRE |
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