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Int J Radiat Oncol Biol Phys. 2003 Oct 1;57(2):362-70.

Four-year biochemical outcome after radioimmunoguided transperineal brachytherapy for patients with prostate adenocarcinoma.

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1
Department of Radiation Oncology, Aultman Hospital, Canton, OH 44708, USA. rje2@po.cwru.edu

Abstract

PURPOSE:

To evaluate 4-year biochemical outcomes for patients with prostate adenocarcinoma who underwent radioimmunoguided (Prostascint) permanent prostate brachytherapy.

METHODS AND MATERIALS:

Eighty patients with clinical T1C-T3A NxM0 prostate cancer underwent ProstaScint-guided prostate brachytherapy using either (103)Pd or (125)I between February 1997 and December 2000. Sixty-seven patients underwent prostate brachytherapy alone, whereas 13 patients received neoadjuvant hormonal manipulation before implantation. Risk factors (RF) included PSA >10, Stage >or=T2b, and Gleason grade >or=7. Sixty patients had low-risk disease (0 RF), 17 were intermediate risk (1 RF), and 3 were high risk (2 RF). Biochemical disease-free survival (bDFS) was calculated using the American Society for Therapeutic Radiology and Oncology (ASTRO) consensus criteria, a PSA cutoff of 1.0 ng/mL, and a PSA cutoff of 0.5 ng/mL.

RESULTS:

Four-year bDFS for the entire cohort was 97.4% using the ASTRO consensus criteria. Low-risk patients (60) had a 4-year bDFS of 100%; intermediate- and high-risk patients (20 patients) were 89.2%. The hormonally naïve group (67 patients) had a 4-year bDFS of 96.9% and a median PSA nadir of 0.2 ng/mL. Median time to nadir was 19.8 months (range: 1.9-53.2 months). For the neoadjuvant hormonal therapy group (13 patients), ASTRO-defined bDFS was 100%. Overall, 85.2% of patients had a posttreatment PSA <or=1.0 ng/mL, and 75.9% had a PSA <or=0.5 ng/mL at a median follow-up of 36 months.

CONCLUSIONS:

At a median follow-up of 36 months, ProstaScint-guided transperineal brachytherapy results in a high probability of actuarial 4-year biochemical disease-free survival for patients with localized prostate cancer.

PMID:
12957246
[Indexed for MEDLINE]
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