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“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.
Those patients were around age 68 with a PSA level of
10.1, 55% had a Gleason score of 6 while 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 therapy 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 survival rate
and prostate
specific survival rates. In order to
decrease or control the size of the prostate, 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%. 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.
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