I-125 or Pd-103 for brachytherapy boost in men with high-risk prostate cancer: A comparison of survival and morbidity outcomes
| Autor: | Nelson N. Stone, Vassilios Skouteris, Richard G. Stock, Barry S. Rosenstein |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
Oncology Biochemical recurrence medicine.medical_specialty Antineoplastic Agents Hormonal Biochemical failure medicine.medical_treatment Brachytherapy Disease-Free Survival 030218 nuclear medicine & medical imaging Iodine Radioisotopes External beam irradiation 03 medical and health sciences Prostate cancer 0302 clinical medicine Risk Factors Internal medicine Humans Medicine Radiology Nuclear Medicine and imaging Stage (cooking) Aged Neoplasm Staging Aged 80 and over Radioisotopes business.industry Proportional hazards model Prostatic Neoplasms Middle Aged Prostate-Specific Antigen medicine.disease 030220 oncology & carcinogenesis Kallikreins Morbidity Neoplasm Grading business Palladium Follow-Up Studies |
| Zdroj: | Brachytherapy. 19:567-573 |
| ISSN: | 1538-4721 |
| DOI: | 10.1016/j.brachy.2020.06.001 |
| Popis: | Brachytherapy boost improves biochemical recurrence rates in men with high-risk prostate cancer (HRPC). Few data are available on whether one isotope is superior to another. We compared the oncologic and morbidity outcomes of I-125 and Pd-103 in men with HRPC receiving brachytherapy.Of 797 patients with HRPC, 190 (23.8%) received I-125 or 607 received Pd-103 with a median of 45 Gy of external beam irradiation. Freedom from biochemical failure (FFBF), freedom from metastases (FFMs), cause-specific survival (CSS), and morbidity were compared for the two isotopes by the ANOVA and the χMen treated with I-125 had a higher stage (p0.001), biological equivalent dose (BED) (p0.001), and longer hormone therapy (neoadjuvant hormone therapy, p0.001), where men treated with Pd-103 had a higher Gleason score (GS, p0.001) and longer followup (median 8.3 vs. 5.3 years, p0.001). Ten-year FFBF, FFM, and CSS for I-125 vs. Pd-103 were 77.5 vs. 80.2% (p = 0.897), 94.7 vs. 91.9% (p = 0.017), and 95.4 vs. 91.8% (p = 0.346), respectively. Men with T3 had superior CSS (94.1 vs. 79.5%, p = 0.001) with I-125. Significant covariates by Cox regression for FFBF were prostate specific antigen (PSA), the GS, and the BED (p0.001), for FFM PSA (p0.001) and GS (p = 0.029), and for CSS PSA, the GS (p0.001) and the BED (p = 0.022). Prostate cancer mortality was 7/62 (15.6%) for BED ≤ 150 Gy, 18/229 (7.9%) for BED150-200 Gy, and 20/470 (5.9%) for BED200 Gy (p = 0.029). Long-term morbidity was not different for the two isotopes.Brachytherapy boost with I-125 and Pd-103 appears equally effective yielding 10-year CSS of over 90%. I-125 may have an advantage in T3 disease. Higher doses yield the most favorable survival. |
| Databáze: | OpenAIRE |
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