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High-dose-rate intensity-modulated brachytherapy with external beam radiotherapy for prostate cancer: California endocurietherapy's 10-year results.
Int J Radiat Oncol Biol Phys. 2005 Apr 01; 61(5):1306-16.IJ

Abstract

PURPOSE

To present the long-term outcome and morbidity of high-dose-rate brachytherapy (HDR-BT) combined with external beam radiotherapy (EBRT) for localized prostate cancer.

METHODS AND MATERIALS

Between September 1991 and December 1998, 209 consecutive patients with no prior androgen suppression were treated with HDR-BT plus EBRT. The median follow-up was 7.25 years (range, 5-12 years). The patients were stratified into three risk groups: low (Stage T2a or less, Gleason score </=6, and prostate-specific antigen [PSA] level </=10 ng/mL), intermediate (Stage T2b,c, Gleason score 7, and PSA level 10-20 ng/mL), and high (Stage T3, Gleason score 8-10, and PSA level >20). Four definitions of PSA progression were compared with the general clinical failure outcome: the American Society for Therapeutic Radiology and Oncology (ASTRO) definition, nadir plus 2.0 ng/mL, two consecutive rises >/=0.5 ng/mL, and PSA level >0.2 ng/mL. Morbidity was scored using Radiation Therapy Oncology Group criteria.

RESULTS

The general clinical control rate was 90% (188 of 209), and the general clinical failure rate was 10% (21 of 209). The overall survival rate was 79%, and the cause-specific survival rate was 97%. The PSA progression-free survival (ASTRO definition) rate was 90%, 87%, and 69% for the low-, intermediate-, and high-risk groups, respectively. The nadir plus 2 ng/mL and two rises >/=0.5 definitions correlated better with the actual clinical outcome than did the ASTRO and PSA >0.2 ng/mL definitions. The rate of Grade 3 and 4 late urinary morbidity was 6.7% and 1%, respectively, mostly occurring in patients who had undergone post-RT transurethral prostate resection. No late Grade 3 or 4 rectal morbidity developed. The sexual potency preservation rate was 67%.

CONCLUSION

Our 10-year results have demonstrated HDR-BT plus EBRT is a proven treatment for all stages of localized prostate cancer. The morbidity was low, but post-RT transurethral resection should be avoided.

Authors+Show Affiliations

California Endocurietherapy Cancer Center, Oakland, CA, USA. jdemanes@cetmc.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15817332

Citation

Demanes, D Jeffrey, et al. "High-dose-rate Intensity-modulated Brachytherapy With External Beam Radiotherapy for Prostate Cancer: California Endocurietherapy's 10-year Results." International Journal of Radiation Oncology, Biology, Physics, vol. 61, no. 5, 2005, pp. 1306-16.
Demanes DJ, Rodriguez RR, Schour L, et al. High-dose-rate intensity-modulated brachytherapy with external beam radiotherapy for prostate cancer: California endocurietherapy's 10-year results. Int J Radiat Oncol Biol Phys. 2005;61(5):1306-16.
Demanes, D. J., Rodriguez, R. R., Schour, L., Brandt, D., & Altieri, G. (2005). High-dose-rate intensity-modulated brachytherapy with external beam radiotherapy for prostate cancer: California endocurietherapy's 10-year results. International Journal of Radiation Oncology, Biology, Physics, 61(5), 1306-16.
Demanes DJ, et al. High-dose-rate Intensity-modulated Brachytherapy With External Beam Radiotherapy for Prostate Cancer: California Endocurietherapy's 10-year Results. Int J Radiat Oncol Biol Phys. 2005 Apr 1;61(5):1306-16. PubMed PMID: 15817332.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High-dose-rate intensity-modulated brachytherapy with external beam radiotherapy for prostate cancer: California endocurietherapy's 10-year results. AU - Demanes,D Jeffrey, AU - Rodriguez,Rodney R, AU - Schour,Lionel, AU - Brandt,David, AU - Altieri,Gillian, PY - 2004/03/30/received PY - 2004/07/27/revised PY - 2004/08/09/accepted PY - 2005/4/9/pubmed PY - 2005/5/11/medline PY - 2005/4/9/entrez SP - 1306 EP - 16 JF - International journal of radiation oncology, biology, physics JO - Int J Radiat Oncol Biol Phys VL - 61 IS - 5 N2 - PURPOSE: To present the long-term outcome and morbidity of high-dose-rate brachytherapy (HDR-BT) combined with external beam radiotherapy (EBRT) for localized prostate cancer. METHODS AND MATERIALS: Between September 1991 and December 1998, 209 consecutive patients with no prior androgen suppression were treated with HDR-BT plus EBRT. The median follow-up was 7.25 years (range, 5-12 years). The patients were stratified into three risk groups: low (Stage T2a or less, Gleason score </=6, and prostate-specific antigen [PSA] level </=10 ng/mL), intermediate (Stage T2b,c, Gleason score 7, and PSA level 10-20 ng/mL), and high (Stage T3, Gleason score 8-10, and PSA level >20). Four definitions of PSA progression were compared with the general clinical failure outcome: the American Society for Therapeutic Radiology and Oncology (ASTRO) definition, nadir plus 2.0 ng/mL, two consecutive rises >/=0.5 ng/mL, and PSA level >0.2 ng/mL. Morbidity was scored using Radiation Therapy Oncology Group criteria. RESULTS: The general clinical control rate was 90% (188 of 209), and the general clinical failure rate was 10% (21 of 209). The overall survival rate was 79%, and the cause-specific survival rate was 97%. The PSA progression-free survival (ASTRO definition) rate was 90%, 87%, and 69% for the low-, intermediate-, and high-risk groups, respectively. The nadir plus 2 ng/mL and two rises >/=0.5 definitions correlated better with the actual clinical outcome than did the ASTRO and PSA >0.2 ng/mL definitions. The rate of Grade 3 and 4 late urinary morbidity was 6.7% and 1%, respectively, mostly occurring in patients who had undergone post-RT transurethral prostate resection. No late Grade 3 or 4 rectal morbidity developed. The sexual potency preservation rate was 67%. CONCLUSION: Our 10-year results have demonstrated HDR-BT plus EBRT is a proven treatment for all stages of localized prostate cancer. The morbidity was low, but post-RT transurethral resection should be avoided. SN - 0360-3016 UR - https://www.unboundmedicine.com/medline/citation/15817332/High_dose_rate_intensity_modulated_brachytherapy_with_external_beam_radiotherapy_for_prostate_cancer:_California_endocurietherapy's_10_year_results_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0360-3016(04)02264-3 DB - PRIME DP - Unbound Medicine ER -