Pretreatment endorectal coil magnetic resonance imaging findings predict biochemical tumor control in prostate cancer patients treated with combination brachytherapy and external-beam radiotherapy Journal Article


Authors: Riaz, N.; Afaq, A.; Akin, O.; Pei, X.; Kollmeier, M. A.; Cox, B.; Hricak, H.; Zelefsky, M. J.
Article Title: Pretreatment endorectal coil magnetic resonance imaging findings predict biochemical tumor control in prostate cancer patients treated with combination brachytherapy and external-beam radiotherapy
Abstract: Purpose: To investigate the utility of endorectal coil magenetic resonance imaging (eMRI) in predicting biochemical relapse in prostate cancer patients treated with combination brachytherapy and external-beam radiotherapy. Methods and Materials: Between 2000 and 2008, 279 men with intermediate- or high-risk prostate cancer underwent eMRI of their prostate before receiving brachytherapy and supplemental intensity-modulated radiotherapy. Endorectal coil MRI was performed before treatment and retrospectively reviewed by two radiologists experienced in genitourinary MRI. Image-based variables, including tumor diameter, location, number of sextants involved, and the presence of extracapsular extension (ECE), were incorporated with other established clinical variables to predict biochemical control outcomes. The median follow-up was 49 months (range, 1-13 years). Results: The 5-year biochemical relapse-free survival for the cohort was 92%. Clinical findings predicting recurrence on univariate analysis included Gleason score (hazard ratio [HR] 3.6, p = 0.001), PSA (HR 1.04, p = 0.005), and National Comprehensive Cancer Network risk group (HR 4.1, p = 0.002). Clinical T stage and the use of androgen deprivation therapy were not correlated with biochemical failure. Imaging findings on univariate analysis associated with relapse included ECE on MRI (HR 3.79, p = 0.003), tumor size (HR 2.58, p = 0.04), and T stage (HR 1.71, p = 0.004). On multivariate analysis incorporating both clinical and imaging findings, only ECE on MRI and Gleason score were independent predictors of recurrence. Conclusions: Pretreatment eMRI findings predict for biochemical recurrence in intermediate- and high-risk prostate cancer patients treated with combination brachytherapy and external-beam radiotherapy. Gleason score and the presence of ECE on MRI were the only significant predictors of biochemical relapse in this group of patients. © 2012 Elsevier Inc.
Keywords: disease-free survival; retrospective studies; major clinical study; combined modality therapy; recurrence risk; magnetic resonance imaging; prostate specific antigen; tumor localization; neoplasm recurrence, local; image analysis; tumor volume; radiotherapy; clinical assessment; patient monitoring; oncology; risk assessment; prostate cancer; gleason score; prostate-specific antigen; prostatic neoplasms; intensity-modulated radiotherapy; tumors; radiotherapy, intensity-modulated; tumor burden; biochemical failure; androgen antagonists; brachytherapy; gleason scores; forecasting; cancer relapse; hazard ratio; external beam radiotherapy; cancer control; multi variate analysis; univariate analysis; analysis of variance; androgen deprivation therapy; radiodiagnosis; biochemical control; prostate cancers; diseases; recurrence free survival; tumor size; image-based; independent predictors; pre-treatment; tumor control; endorectal coil magnetic resonance imaging; biochemical tumor control; neoplasm grading; biochemical relapse-free survival; endorectal coil mri
Journal Title: International Journal of Radiation Oncology, Biology, Physics
Volume: 84
Issue: 3
ISSN: 0360-3016
Publisher: Elsevier Inc.  
Date Published: 2012-11-01
Start Page: 707
End Page: 711
Language: English
DOI: 10.1016/j.ijrobp.2012.01.009
PROVIDER: scopus
PUBMED: 22425220
DOI/URL:
Notes: --- - "Export Date: 2 November 2012" - "CODEN: IOBPD" - "Source: Scopus"
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MSK Authors
  1. Brett Wayne Cox
    63 Cox
  2. Michael J Zelefsky
    749 Zelefsky
  3. Nadeem Riaz
    374 Riaz
  4. Marisa A Kollmeier
    213 Kollmeier
  5. Hedvig Hricak
    405 Hricak
  6. Oguz Akin
    254 Akin
  7. Asim Ahmed Afaq
    13 Afaq
  8. Xin Pei
    125 Pei