Long-term outcomes and prognostic factors in patients treated with intraoperatively planned prostate brachytherapy

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• 作者：Carlos Vargas¹ ; ^{cvargas@frogdocs.com} ; Douglas Swartz² ; Apoorva Vashi² ; Mark Blasser³ ; Ali Kasareian⁴ ; Jamie Cesaretti¹ ; Kathleen Kiley¹ ; Mitchell Terk¹
• 关键词：External beam radiation therapy ; Brachytherapy ; Prostate-specific antigen ; Biochemical control ; Overall survival ; Toxicity ; Outcomes ; Prostate cancer
• 刊名：Brachytherapy
• 出版年：2013
• 出版时间：March-April, 2013
• 年：2013
• 卷：12
• 期：2
• 页码：120-125
• 全文大小：231 K

文摘

Purpose

Evaluate outcomes and prognostic factors in men with localized prostate cancer.

Methods and Materials

A total of 3760 patients have undergone prostate seed implantation at our institution. This review is of our initial 304 consecutive patients treated before January 30, 2001. A total of 124 patients were treated with ¹²⁵I implant monotherapy and 180 with ¹⁰³Pd implant combined with 45-Gy external beam radiation therapy.

Results

The median followup was 10.3 years. A 10-year biochemical control for low risk (LR) was 98 % , intermediate risk (IR) 94 % , high risk (HR) 78 % , and HR with one HR factor 88 % (p?<?0.001); cause-specific survival was 99 % , 98 % , and 84 % for LR, IR, and HR, respectively (p < 0.001); No significant difference in outcome was seen for LR and IR patients (p > 0.3). On multivariate analysis, only pretreatment PSA, Gleason score, and T-stage were significant for biochemical control. Most biochemical failures occurred within 5 years (93 % ).

Conclusions

With a minimum followup of 10 years, results are excellent and do not differ for LR or IR prostate cancer patients. HR patients are a very heterogeneous group, and excellent results can still be achieved for HR patients with only one HR feature.