Long-term biochemical outcomes using cesium-131 in prostate brachytherapy
| Autor: | Neha P. Amin, Stephanie R. Rice, Arpit M. Chhabra, Manuj Agarwal, Brian J. Moran, Michelle H. Braccioforte |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Urinary system Brachytherapy Urology 030218 nuclear medicine & medical imaging Management of prostate cancer 03 medical and health sciences 0302 clinical medicine Prostate Biomarkers Tumor medicine Humans Radiology Nuclear Medicine and imaging Aged Drug Implants business.industry Prostatectomy Prostatic Neoplasms Cancer Dose-Response Relationship Radiation Middle Aged Prostate-Specific Antigen medicine.disease United States Survival Rate Radiation therapy Treatment Outcome medicine.anatomical_structure Oncology Cesium Radioisotopes 030220 oncology & carcinogenesis business Prostate brachytherapy Follow-Up Studies |
| Zdroj: | Brachytherapy. 18:800-805 |
| ISSN: | 1538-4721 |
| DOI: | 10.1016/j.brachy.2019.07.002 |
| Popis: | Purpose Long-term outcomes reveal equivalent biochemical outcomes with low-dose-rate (LDR) brachytherapy (BT) compared with radical prostatectomy and external-beam radiotherapy for the management of prostate cancer. Iodine-125, the most commonly used isotope, may be associated with long-term urinary consequences. Cesium-131 (131Cs) has a higher dose rate and shorter dose delivery time, predicting a shorter duration of urinary morbidity. We report our institution's high-volume experience and the most mature data to date on outcomes with 131Cs prostate BT. Methods and Materials 571 men (median age: 65.38 years) with low (55%)-, intermediate (36%)-, and high-risk disease (9%) received monobrachytherapy, dual-modality, or trimodality using 131Cs at a single institution. Risk groups were defined according to the National Comprehensive Cancer Network definition. Median prescription dose for definitive LDR-BT and LDR-BT boost was 115 Gy and 70 Gy, respectively. Median initial PSA was 6.1 ng/mL (IQR: 4.6–8.7). Results Median followup time was 5 years. 5/7-year overall survival for low-, intermediate-, and high-risk patients was 96.9%/96/9%, 92.8%/89.7%, and 95.8%/87.1%, respectively (p = 0.02). 5/7-year freedom from biochemical failure for low-, intermediate-, and high-risk patients was 98.5%/96.3%, 94.1%/86.4%, and 93.2%/74.5%, respectively (p Conclusions 131Cs is a viable alternative isotope for prostate brachytherapy for organ-confined disease. Long-term biochemical control and survival outcomes are excellent and on par with those attained with the use of 125I or 103Pd. This report therefore supports the continued use of 131Cs as an effective and comparable alternative isotope. |
| Databáze: | OpenAIRE |
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