Combined brachytherapy and external beam radiotherapy without adjuvant androgen deprivation therapy for high-risk prostate cancer

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• 作者：Toshio Ohashi (7) (8)
  Atsunori Yorozu (9)
  Shiro Saito (10)
  Tetsuo Momma (11)
  Toru Nishiyama (10)
  Shoji Yamashita (8)
  Yutaka Shiraishi (7)
  Naoyuki Shigematsu (7)
  
• 关键词：Prostate cancer ; Brachytherapy ; High risk ; Androgen deprivation therapy
• 刊名：Radiation Oncology
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：9
• 期：1
• 全文大小：254 KB
• 作者单位：Toshio Ohashi (7) (8)
  Atsunori Yorozu (9)
  Shiro Saito (10)
  Tetsuo Momma (11)
  Toru Nishiyama (10)
  Shoji Yamashita (8)
  Yutaka Shiraishi (7)
  Naoyuki Shigematsu (7)
  
  7. Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
  8. Department of Radiology, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wakho City, Saitama, 351-0102, Japan
  9. Department of Radiology, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
  10. Department of Urology, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo, 152-8902, Japan
  11. Department of Urology, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wakho City, Saitama, 351-0102, Japan
  
• ISSN：1748-717X

文摘

Background To report the outcomes of patients treated with combined iodine-125 (I-125) brachytherapy and external beam radiotherapy (EBRT) for high-risk prostate cancer. Methods Between 2003 and 2009, I-125 permanent prostate brachytherapy plus EBRT was performed for 206 patients with high-risk prostate cancer. High-risk patients had prostate-specific antigen?≥-0?ng/mL, and/or Gleason score?≥-, and/or Stage?≥?T3. One hundred and one patients (49.0%) received neoadjuvant androgen deprivation therapy (ADT) but none were given adjuvant ADT. Biochemical failure-free survival (BFFS) was determined using the Phoenix definition. Results The 5-year actuarial BFFS rate was 84.8%. The 5-year cause-specific survival and overall survival rates were 98.7% and 97.6%, respectively. There were 8 deaths (3.9%), of which 2 were due to prostate cancer. On multivariate analysis, positive biopsy core rates and the number of high-risk factors were independent predictors of BFFS. The 5-year BFFS rates for patients in the positive biopsy core rate <50% and ?0% groups were 89.3% and 78.2%, respectively (p = 0.03). The 5-year BFFS rate for patients with the any single high-risk factor was 86.1%, compared with 73.6% for those with any 2 or all 3 high-risk factors (p = 0.03). Neoadjuvant ADT did not impact the 5-year BFFS. Conclusions At a median follow-up of 60 months, high-risk prostate cancer patients undergoing combined I-125 brachytherapy and EBRT without adjuvant ADT have a high probability of achieving 5-year BFFS.