TY - JOUR
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
Y1 - 2012/5
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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U2 - 10.1016/j.brachy.2011.05.011
DO - 10.1016/j.brachy.2011.05.011
M3 - Article
C2 - 21727033
AN - SCOPUS:84859740563
VL - 11
SP - 209
EP - 213
JO - Brachytherapy
JF - Brachytherapy
SN - 1538-4721
IS - 3
ER -