“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.