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Brachytherapy. 2008 Jul-Sep;7(3):217-22. doi: 10.1016/j.brachy.2008.04.002.

Distant and local recurrence in patients with biochemical failure after prostate brachytherapy.

Author information

1
Department of Radiation Oncology, Mount Sinai School of Medicine, 1184 5th Avenue, New York, NY 10025, USA. richard.stock@mountsinai.org

Abstract

PURPOSE:

To analyze the patterns of failure after the brachytherapy management of localized prostate cancer.

METHODS AND MATERIALS:

From 1990 to 2008, 2869 patients underwent prostate brachytherapy and 213 experienced a prostate-specific antigen (PSA) failure by the Phoenix definition. Of these 213 patients, 33.5% were low, 18.5% intermediate, and 58% high risk.

RESULTS:

Of the 119 patients biopsied, 36 (30%) had a least one positive posttreatment biopsy. In univariate and multivariate analyses, PSA doubling time was the most predictive of a positive biopsy. Patients with doubling times < or =3, >3-6, > or =6-10, and >10 months had positive biopsy rates of 9%, 18%, 36%, and 42%, respectively (p=0.01). The actuarial rate of remaining free from distant metastases at 10 years was 73%. Patients with PSA doubling times of < or =3, >3-6, >6-10, and >10 months had freedom from distant metastases rates of 0%, 74%, 78%, and 94.5% at 10 years, respectively (p<0.0001). In multivariate analysis, PSA doubling time and time to PSA failure were the most significant predictors of developing distant metastases.

CONCLUSIONS:

About one third of patients harbor a component of local failure and one fourth demonstrate clinical metastases. PSA doubling time can be used to help predict the source of a rising PSA.

PMID:
18635024
DOI:
10.1016/j.brachy.2008.04.002
[Indexed for MEDLINE]

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