AIM:Brachytherapy is an adequate option as monotherapy for localised prostate cancer.
The objective of this study was to evaluate and compare biochemical failure free survival (BFFS) after low-dose-rate brachytherapy (LDRB) alone for patients with prostate cancer using ASTRO and Phoenix criteria, and detect prognostic factors.
METHODS: Data on 220 patients treated between 1998 and 2002 with LDRB were retrospectively analysed. Neoadjuvant hormone therapy was used in 74 (33.6%) patients.
RESULTS: Median follow-up was 53.5 months (24-116). Five year BFFS was 83.0% and 83.7% using, respectively, the ASTRO and Phoenix criteria. Low -and intermediate- risk patients presented, respectively, 86.7% and 77.8% 5-year BFFS using the ASTRO definition (p=0.069), and 88.5% and 78.6% considering the Phoenix criteria (p=0.016). Bounce was observed in 66 (30%) patients. Multivariate analysis detected PSA at diagnosis < 10 ng/ml and less than 50% positive biopsy fragments as favourable prognostic factors, regarding BF using both criteria. For the Phoenix criteria, also Gleason score < 7 and low-risk group were identified as independent favourable prognostic factors.
CONCLUSIONS: LDRB alone should be considered mostly for low-risk patients. PSA level was a strong independent prognostic factor. We support the use of the Phoenix criteria for detection of BF in patients submitted to LDRB alone.
Written by:
Pereira da Ponte Amadei L, Fernandes Silva JL, Abdallah Hanna S, Kalil Haddad CM, João Nesrallah A, Andrade Carvalho H. Are you the author?
Departmento de Radiologia/Radioterapia, Faculdade de Medicina da Universidade de São Paulo and Sociedade Beneficente de Senhoras, São Paulo, SP, Brazil.
Reference: Clin Transl Oncol. 2012 May;14(5):369-75.
PubMed Abstract
PMID: 22551543
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