“12-Year Outcomes Following Permanent Prostate Brachytherapy in Patients with Clinically Localized Prostate Cancer”
Louis Potters, Carol Morgenstern, Emil Calugaru, Paul Fearn, Anup Jassal, Joseph Presser and Edward Mullen The Journal of Urology 173 (2005) 1562-1566
Physicians reviewed the postoperative outcomes of 1,449 consecutive prostate cancer patients treated with permanent brachytherapy between 1992 and 2000. These patients were generally around 68 with a PSA level of 10.1, 55% had a Gleason score of 6 and 28% had a Gleason score of 7. For many, brachytherapy was not their initial or only treatment. There were 400 patients (27%) who received neoadjuvant hormone therapy and 301 (20%) received a combination of external radiation and brachytherapy. After 82 months, 39 patients were at risk for 144 months. The overall survival rate 12 years following was 81% and the disease specific survival rate was 93%. After 12 years the American Society for Therapeutic Radiology and Oncology (ASTRO) defined the biochemical-free recurrence at 81%, ASTRO-Kattan at 78%, ASTRO-Last Call at 74%, and Houston at 77%. Using the ASTRO-Kattan definition, patients at low risk could achieve 89% biochemical-free recurrence, those at intermediate risk 78%, and those at high risk 63%.
“Impact of Short Course Hormonal Therapy on Overall and Cancer Specific Survival After Permanent Prostate Brachytherapy”
David C. Beyer, M.D., Timothy McKeough, and Theresa Thomas, M.S. Int. J. Radiation Oncology Biol. Phys., Vol. 61 No. 5 pp. 1299-1305, 2005
This study reviewed 2,378 consecutive patients from 1988 through 2001. Doctors hoped to establish the impact of hormone therapy given prior to brachytherapy through the results of 10-year overall and prostate specific survival rates. In order to decrease the size of the prostate or at the discretion of the physician, hormone therapy was given to 464 patients before the seed implant. Risk groups were defined based on PSA level, Gleason score, and prostate cancer stage. Doctors followed up with patients ranging up to 12.6 years. During this time 477 patients died, 67 due to prostate cancer. Generally at 10 years the overall survival rate was 43% and the cause-specific survival rate was 88%. For those that did not receive hormone therapy prior to brachytherapy, the overall survival was 44% and cancer specific was 89%. Those that did receive this form of treatment combination, the survival rate was 20% and cancer specific was 81%. Those that did receive this form of treatment combination the survival rate was 20% and cancer specific was 81%. This study concluded that after 10 years patients who received hormone therapy before brachytherapy had worse overall survival rates than those who received brachytherapy alone.
“European Collaborative Group on Prostate Brachytherapy: Preliminary Report in 1175 Patients.”
S. Langleya, R. Laingb, A. Hendersona, S. Aaltomaac, V. Katajad, J.-E. Palmgrend, F. Bladoue, N. Salemf, G. Sermente, L. Navag, A. Losah, G. Guazzonih, F. Guedeai, F. Aguiloj, J.F. Suarezj
European Urology 46 (2004) 565570
The goal of this study was to create a multi-center database of a large span of prostate cancer patients treated with brachytherapy across Europe. To reach this goal 1,175 patients files were included, all of which were registered due to the comprehensive data presented. A patient follow-up was given at five years. Prior hormone therapy treatments were reported in 492 of 1,175 patients (41.9%). France, UK, and Finland reported administering 270 of 860 (31.4%) patients with an antiandrogen and 206 of 860 (24.0%) with a luteinising hormone-releasing hormone (LHRH). Also, 118 patients from France and Italy received electron beam radiation therapy. After a thorough analysis of the database, the study revealed that patient selection has been made optimal both in terms of brachytherapy outcomes and side effects. These results prove that physicians are able to refine treatment choice and administration for their patients. Furthermore, the database indicates that brachytherapy is a well-established treatment option for prostate cancer.