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“High and intermediate risk prostate cancer treated with three-dimensional computed tomography-guided brachytherapy: 2-8 year follow-up”
Panos G. Koutrouvelisa, Jay Gillenwater, Niko Lailas, Fred Hendricks, Stuart Katz, James Sehn, Guillermo Gil-Montero, Nabil Khawand. Radiotherapy and Oncology 67 (2003) 303–308
In this study doctors wanted to
report brachytherapy
results in high and intermediate risk prostate
cancer patients. In order to reach overall conclusions,
they studied 356 consecutive high and intermediate risk
patients who were treated with three-dimensional computed
tomography-guided stereotactic pararectal brachytherapy
from June 1994 to June 2000. The approximate age was
68, initial prostate volume was 59cm, and initial PSA
level was 10.5. At a follow-up of 2-8 years, 348 patients
were available. Out of the 348, 280 patients were high
risk with either a PSA greater than 20, a Gleason score
greater than 7, and/or a prostate cancer stage T2b,
T3a, or T3b. Intermediate risk patients exhibited only
one of these factors. Patients treated with prior transurethral
resection consisted of 30 (9%) and those treated with
three months neoadjuvant
androgen ablation, or a particular
prior hormone
therapy, consisted of 229 (64%). Two hundred and
eighty high-risk patients experienced a biochemical
disease-free survival rate of 92%, and 68 intermediate
risk patients experienced 96%. The results of this study
conclude a high level of biochemical control of 2-8
years.
“Prostate Cancer with Large Glands Treated with 3-Dimensional Computerized Tomography Guided Pararectal Brachytherapy: up to 8 years of follow-up”
Panos G. Koutrouvelisa, Niko Lailas, Stuart Katz, James Sehn, Guillermo Gil-Montero and Nabil Khawand. The Journal of Urology, Vol. 169, 1331–1336, April 2003
This study resembles the one above,
the major difference being that physicians in this study
focused on reporting brachytherapy results in patients
with cancer in an exclusively large prostate. Here,
in order to reach general assessments, doctors studied
331 consecutive patients with a large prostate of 50-180cm
that were treated with 3-dimensional computerized tomography
guided brachytherapy from June 1994 to June 2000. The
approximate age was 69 and 327 patients were available
for follow-up for 2-8 years. Patients at high risk had
either a PSA greater than 20, a Gleason
score greater than 7, or stage T2b,
T3a, or T3b. If they exhibited two intermediate risk
factors they were considered high risk as well. Those
at intermediate risk exhibited only one high risk factor.
To be considered low risk, patients needed to have a
PSA
less than 10, Gleason less than 7, and stage T1a, b,
c, or T2a. Patients treated with prior transurethral
resection consisted of 31 (9%) and those treated with
three months of neoadjuvant androgen ablation consisted
of 198 (60%). Of the 12 patients at high risk, 90% experienced
a biochemical
disease-free survival (BDFS). Of the
52 at intermediate risk, 96% had BDFS and of the 93
at low risk, 99% had BDFS. This form of treatment in
the confines of this study resulted in a high level
of biochemical control for 2-8 years in patients with
a large prostate.
“Three-dimensional computed tomography-guided monotherapy pararectal brachytherapy of prostate cancer with seminal vesicle invasion”
Panos Koutrouvelis, Niko Lailas, Fred Hendricks, Guillermo Gil-Montero, James Sehn, Stuart Katz. Radiotherapy and Oncology 60 (2001) 31 – 35
The focus of this study was to evaluate
the results of 362 patients with prostate cancer and
seminal
vesicle invasion that were referred
to receive one therapy three dimensional computed tomography-guided
posterior pararectal brachytherapy. Of the 362, 43 patients
were upstaged to T3c and 37 were actually treated with
this method. Once receiving the implant, no patient
was treated with hormone therapy. The results of this
study were extensive, but generally speaking this procedure
delivered adequate dosage to the seminal vesicles and
in patients with low initial PSA levels (regardless
of Gleason scores) the clinical and biochemical outcomes
were encouraging.
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