PURPOSE: This report addresses the question of whether there is durable cancer control, defined by prostate specific antigen cut point < 0.2 ng/ml, of prostate cancer >20 years after irradiation of this disease.
Additionally, late recurrence, defined as recurrence after 10 year follow up, is evaluated.
MATERIAL AND METHODS: From 1984 - 2000, 3,546 consecutive hormone naïve men were treated by an I-125 prostate implant (retropubic and later transperineal) followed by external beam irradiation. Recurrence is defined by a prostate specific antigen rise >0.20 ng/ml or a prostate specific antigen nadir >0.20 ng/ml. The median follow up is 11 years (range, 3 months - 26 years).
RESULTS: For all men, the 10, 15, 20, and 25 year disease free survival rate is 75%, 73%, 73% and 73%, respectively, with the longest time to recurrence at 15.5 year follow up. Of 313 recurrent men treated 16-25 years ago, 5% of recurrences were late. For men implanted by the transperineal method since 1995, the 15 year disease free survival rate is 79%.
CONCLUSION: This study documents that with this irradiation program, cancer control, defined by the recurrence definition used for radical prostatectomy, is durable with no further recurrences between 15.5 - 25 year follow up. This study also suggests that at least 15 year follow up is necessary to fully evaluate any treatment for prostate cancer. Further, if a man's prostate specific antigen is < 0.20 ng/ml 15 years posttreatment, later recurrence should be unlikely.
Written by:
Critz FA, Benton JB, Shrake P, Merlin ML. Are you the author?
Radiotherapy Clinics of Georgia, Atlanta, Georgia.
Reference: J Urol. 2012 Oct 24. pii: S0022-5347(12)05342-6
doi: 10.1016/j.juro.2012.10.061
PubMed Abstract
PMID: 23103235
UroToday.com Prostate Cancer Section
