Outcomes following iodine-125 brachytherapy in patients with Gleason 7, intermediate risk prostate cancer: A population-based cohort study

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• 作者：Christopher Herbert^a ; ^{cherbert@bccancer.bc.ca} ; W. James Morris^a ; Mira Keyes^a ; Jeremy Hamm^b ; Vincent Lapointe^a ; Michael McKenzie^a ; Thomas Pickles^a ; Ingrid Spadinger^a
• 关键词：Prostate cancer ; Brachytherapy ; Gleason 7 ; Biochemical recurrence
• 刊名：Radiotherapy and Oncology
• 出版年：2012
• 期刊代码：231_01678140
• 类别：med
• 出版时间：May, 2012
• 卷：103
• 期：2
• 页码：228-232
• 文件大小：301 K

摘要

Background and purpose

To evaluate outcome in patients with Gleason 7 prostate cancer treated with iodine-125 brachytherapy at the British Columbia Cancer Agency.

Materials and methods

Between 20th July 1998 and 7th February 2006, 1500 patients underwent I-125 prostate brachytherapy without supplemental external beam radiation therapy. Of these, 439 had Gleason 7 disease; 362 had Gleason 3 + 4 and 77 had 4 + 3 disease. Generally, patients received 6 months of androgen suppression. We compared biochemical no evidence of disease (bNED) between patients with Gleason 猢? and Gleason 7 and between Gleason 3 + 4 and 4 + 3 using the Phoenix definition of biochemical recurrence.

Results

Median follow-up was 60 months. Estimated 5 year bNED was 97%for patients with Gleason score 猢? and 94%for patients with Gleason 7 disease (p = 0.037). Estimated bNED was 95%and 94%for 3 + 4 and 4 + 3, respectively (p = 0.791). There was no difference in bNED between implants achieving D90 猢?#xA0;versus < the median value (150.5 Gy) or 猢?#xA0;versus < 140 Gy.

Conclusions

I-125 brachytherapy with 6 months of ADT demonstrates excellent bNED rates in Gleason 7 disease. We found no evidence of a difference between patients with Gleason 3 + 4 versus 4 + 3 disease.