Treatment results of brachytherapy vs. external beam radiation therapy for intermediate-risk prostate cancer with 10-year followup
| Autor: | Margaret S. Soper, Barry W. Goy, Jeff Slezak, Michael Tome, H. Cosmatos, Tangel Chang |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty Antineoplastic Agents Hormonal medicine.medical_treatment Brachytherapy Salvage therapy 030218 nuclear medicine & medical imaging Androgen deprivation therapy 03 medical and health sciences Prostate cancer 0302 clinical medicine Prostate Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Propensity Score Aged Retrospective Studies Aged 80 and over Salvage Therapy business.industry Prostatic Neoplasms Radiotherapy Dosage Middle Aged Prostate-Specific Antigen medicine.disease Radiation therapy medicine.anatomical_structure Chemotherapy Adjuvant 030220 oncology & carcinogenesis Cohort Propensity score matching Radiology business Follow-Up Studies |
| Zdroj: | Brachytherapy. 15(6) |
| ISSN: | 1873-1449 |
| Popis: | To compare 10-year treatment outcomes of brachytherapy vs. external beam radiation therapy for patients with intermediate-risk prostate cancer (IRPC).Between 2004 and 2007, 93 IRPC patients underwent brachytherapy using iodine-125 to a dose of 145 Gy without supplemental external radiation. A retrospective comparison was performed to a contemporary cohort of 597 patients treated with external beam radiation therapy to a median dose of 75.3 Gy using a propensity score-matched analysis.Median followup was 7.8 years. With brachytherapy, 51.6% had Gleason score 7 vs. 72.0% for external radiation (p0.001). Median initial prostate-specific antigen was 8.3 for brachytherapy vs. 9.4 for external radiation (p = 0.01). Neoadjuvant androgen deprivation therapy was given in 59.5% of external radiation vs. 10.8% of brachytherapy patients (p0.001). The 10-year freedom from biochemical failure (FFBF) for brachytherapy was 81.7% vs. 54.5% for external radiation (p = 0.002). Unfavorable intermediate-risk patients experienced borderline significant improved FFBF with brachytherapy (p = 0.08). The 10-year freedom from salvage therapy for brachytherapy was 93.2% vs. 72.2% for external radiation (p = 0.006). There were no significant differences in distant metastases-free survival, prostate cancer-specific survival, or overall survival after adjusting for age. Multivariate analysis with propensity score matching showed that brachytherapy remained an independent predictor for improved FFBF (p = 0.007). Grade 1 and 2 late rectal complication rate was 6.5% for brachytherapy vs. 15.2% for external radiation (p = 0.02).Brachytherapy using iodine-125 without supplemental external radiation is a reasonable treatment option for selected IRPC patients. |
| Databáze: | OpenAIRE |
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