Biochemical and clinical experience with real-time intraoperatively planned permanent prostate brachytherapy

Wilhelm Lubbe, Randi Cohen, Navesh Sharma, Karen Ruth, Ruth Peters, Jinsheng Li, Mark Buyyounouski, Alexander Kutikov, David Chen, Robert Uzzo, Eric Horwitz

Research output: Contribution to journalArticle

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Abstract

Purpose: To evaluate patient characteristics and dosimetric parameters that predict biochemical failure (BCF) after real-time planned low-dose-rate prostate brachytherapy. Methods: From 1998 to 2008, a low-risk cohort by National Comprehensive Cancer Network criteria of 341 men with a median followup of 41.6 months was analyzed. This cohort had a median age of 65.1 years, prostate volume of 35.8. cc, and pretreatment prostate-specific antigen of 5.6. ng/mL. Patients had predominately Gleason 6 (95.9%) and T1c (81.3%) disease. About 3.6% of the patients received androgen deprivation therapy. Kaplan-Meier and Cox proportional hazards survival analysis methods were used to analyze predictors of BCF (Phoenix definition). Results: At 72 months, freedom from BCF was 91.1% (95% confidence interval=85.0-94.8). The median D 90 was 145.9Gy, and the median V 100 was 90.3%. Because of infrequent BCF, the following prostate volume groups were examined: 15-<25, 25-<35, 35-<45, and 45+cc. Of all possible predictors, only small prostate volume (15-<25cc group) was significantly associated with BCF (hazard ratio=8.44, 95% confidence interval=1.82-39.14, p=0.007). Using Kaplan-Meier analysis, time to BCF was also significantly increased in the lowest prostate volume 15-<25cc group with 24.1% failing at 48 months compared with 1.6-5.1% among the other groups. Conclusions: Real-time planned low-dose-rate prostate brachytherapy provides excellent biochemical control as a single-agent treatment for low-risk prostate cancer with 91.1% freedom from BCF at 72 months. Only prostate volume less than 25. cc was an independent predictor of BCF.

Original languageEnglish (US)
Pages (from-to)209-213
Number of pages5
JournalBrachytherapy
Volume11
Issue number3
DOIs
StatePublished - May 1 2012

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Brachytherapy
Prostate
Confidence Intervals
Kaplan-Meier Estimate
Prostate-Specific Antigen
Survival Analysis
Androgens
Prostatic Neoplasms
Therapeutics
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Lubbe, Wilhelm ; Cohen, Randi ; Sharma, Navesh ; Ruth, Karen ; Peters, Ruth ; Li, Jinsheng ; Buyyounouski, Mark ; Kutikov, Alexander ; Chen, David ; Uzzo, Robert ; Horwitz, Eric. / Biochemical and clinical experience with real-time intraoperatively planned permanent prostate brachytherapy. In: Brachytherapy. 2012 ; Vol. 11, No. 3. pp. 209-213.
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title = "Biochemical and clinical experience with real-time intraoperatively planned permanent prostate brachytherapy",
abstract = "Purpose: To evaluate patient characteristics and dosimetric parameters that predict biochemical failure (BCF) after real-time planned low-dose-rate prostate brachytherapy. Methods: From 1998 to 2008, a low-risk cohort by National Comprehensive Cancer Network criteria of 341 men with a median followup of 41.6 months was analyzed. This cohort had a median age of 65.1 years, prostate volume of 35.8. cc, and pretreatment prostate-specific antigen of 5.6. ng/mL. Patients had predominately Gleason 6 (95.9{\%}) and T1c (81.3{\%}) disease. About 3.6{\%} of the patients received androgen deprivation therapy. Kaplan-Meier and Cox proportional hazards survival analysis methods were used to analyze predictors of BCF (Phoenix definition). Results: At 72 months, freedom from BCF was 91.1{\%} (95{\%} confidence interval=85.0-94.8). The median D 90 was 145.9Gy, and the median V 100 was 90.3{\%}. Because of infrequent BCF, the following prostate volume groups were examined: 15-<25, 25-<35, 35-<45, and 45+cc. Of all possible predictors, only small prostate volume (15-<25cc group) was significantly associated with BCF (hazard ratio=8.44, 95{\%} confidence interval=1.82-39.14, p=0.007). Using Kaplan-Meier analysis, time to BCF was also significantly increased in the lowest prostate volume 15-<25cc group with 24.1{\%} failing at 48 months compared with 1.6-5.1{\%} among the other groups. Conclusions: Real-time planned low-dose-rate prostate brachytherapy provides excellent biochemical control as a single-agent treatment for low-risk prostate cancer with 91.1{\%} freedom from BCF at 72 months. Only prostate volume less than 25. cc was an independent predictor of BCF.",
author = "Wilhelm Lubbe and Randi Cohen and Navesh Sharma and Karen Ruth and Ruth Peters and Jinsheng Li and Mark Buyyounouski and Alexander Kutikov and David Chen and Robert Uzzo and Eric Horwitz",
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Lubbe, W, Cohen, R, Sharma, N, Ruth, K, Peters, R, Li, J, Buyyounouski, M, Kutikov, A, Chen, D, Uzzo, R & Horwitz, E 2012, 'Biochemical and clinical experience with real-time intraoperatively planned permanent prostate brachytherapy', Brachytherapy, vol. 11, no. 3, pp. 209-213. https://doi.org/10.1016/j.brachy.2011.05.011

Biochemical and clinical experience with real-time intraoperatively planned permanent prostate brachytherapy. / Lubbe, Wilhelm; Cohen, Randi; Sharma, Navesh; Ruth, Karen; Peters, Ruth; Li, Jinsheng; Buyyounouski, Mark; Kutikov, Alexander; Chen, David; Uzzo, Robert; Horwitz, Eric.

In: Brachytherapy, Vol. 11, No. 3, 01.05.2012, p. 209-213.

Research output: Contribution to journalArticle

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T1 - Biochemical and clinical experience with real-time intraoperatively planned permanent prostate brachytherapy

AU - Lubbe, Wilhelm

AU - Cohen, Randi

AU - Sharma, Navesh

AU - Ruth, Karen

AU - Peters, Ruth

AU - Li, Jinsheng

AU - Buyyounouski, Mark

AU - Kutikov, Alexander

AU - Chen, David

AU - Uzzo, Robert

AU - Horwitz, Eric

PY - 2012/5/1

Y1 - 2012/5/1

N2 - Purpose: To evaluate patient characteristics and dosimetric parameters that predict biochemical failure (BCF) after real-time planned low-dose-rate prostate brachytherapy. Methods: From 1998 to 2008, a low-risk cohort by National Comprehensive Cancer Network criteria of 341 men with a median followup of 41.6 months was analyzed. This cohort had a median age of 65.1 years, prostate volume of 35.8. cc, and pretreatment prostate-specific antigen of 5.6. ng/mL. Patients had predominately Gleason 6 (95.9%) and T1c (81.3%) disease. About 3.6% of the patients received androgen deprivation therapy. Kaplan-Meier and Cox proportional hazards survival analysis methods were used to analyze predictors of BCF (Phoenix definition). Results: At 72 months, freedom from BCF was 91.1% (95% confidence interval=85.0-94.8). The median D 90 was 145.9Gy, and the median V 100 was 90.3%. Because of infrequent BCF, the following prostate volume groups were examined: 15-<25, 25-<35, 35-<45, and 45+cc. Of all possible predictors, only small prostate volume (15-<25cc group) was significantly associated with BCF (hazard ratio=8.44, 95% confidence interval=1.82-39.14, p=0.007). Using Kaplan-Meier analysis, time to BCF was also significantly increased in the lowest prostate volume 15-<25cc group with 24.1% failing at 48 months compared with 1.6-5.1% among the other groups. Conclusions: Real-time planned low-dose-rate prostate brachytherapy provides excellent biochemical control as a single-agent treatment for low-risk prostate cancer with 91.1% freedom from BCF at 72 months. Only prostate volume less than 25. cc was an independent predictor of BCF.

AB - Purpose: To evaluate patient characteristics and dosimetric parameters that predict biochemical failure (BCF) after real-time planned low-dose-rate prostate brachytherapy. Methods: From 1998 to 2008, a low-risk cohort by National Comprehensive Cancer Network criteria of 341 men with a median followup of 41.6 months was analyzed. This cohort had a median age of 65.1 years, prostate volume of 35.8. cc, and pretreatment prostate-specific antigen of 5.6. ng/mL. Patients had predominately Gleason 6 (95.9%) and T1c (81.3%) disease. About 3.6% of the patients received androgen deprivation therapy. Kaplan-Meier and Cox proportional hazards survival analysis methods were used to analyze predictors of BCF (Phoenix definition). Results: At 72 months, freedom from BCF was 91.1% (95% confidence interval=85.0-94.8). The median D 90 was 145.9Gy, and the median V 100 was 90.3%. Because of infrequent BCF, the following prostate volume groups were examined: 15-<25, 25-<35, 35-<45, and 45+cc. Of all possible predictors, only small prostate volume (15-<25cc group) was significantly associated with BCF (hazard ratio=8.44, 95% confidence interval=1.82-39.14, p=0.007). Using Kaplan-Meier analysis, time to BCF was also significantly increased in the lowest prostate volume 15-<25cc group with 24.1% failing at 48 months compared with 1.6-5.1% among the other groups. Conclusions: Real-time planned low-dose-rate prostate brachytherapy provides excellent biochemical control as a single-agent treatment for low-risk prostate cancer with 91.1% freedom from BCF at 72 months. Only prostate volume less than 25. cc was an independent predictor of BCF.

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