The role of external radiotherapy in patients treated with permanent prostate brachytherapy Journal Article
| Authors: | Potters, L.; Fearn, P.; Kattan, M. |
| Article Title: | The role of external radiotherapy in patients treated with permanent prostate brachytherapy |
| Abstract: | To examine the difference in Prostate Specific Antigen (PSA)-Relapse Free Survival (RFS) in patients (pts) with prostate cancer treated with permanent prostate brachytherapy (PPB) alone (monotherapy) or combined modality PPB and external radiotherapy (CMT) by a matched pair analysis. There were 1476 pts who were treated loosely based on the American Brachytherapy Society criteria for monotherapy or CMT. PSA-RFS was based upon the Kattan modification of the ASTRO consensus panel definition. A computer generated matching process was undertaken to produce two equally weighted pairs of patients divided by treatment methodology and Kaplan-Meier PSA-RFS curves were generated and compared by X2 testing. All pts were treated between 1992 and 2000 with a 6-y PSA-RFS of 81.9%. The median follow-up was 34.7 months. Patients treated with CMT presented with higher pre-treatment PSA values, Gleason sum score, clinical stage, risk classification, and were more likely to be treated with neoadjuvant hormones. A matched-pair analysis with 314 pts in each group was created stratified by the addition of neoadjuvant hormones, Gleason score sum and the pretreatment PSA value. Actuarial 5-y PSA-RFS was 77.0% for the monotherapy group and 81.1% for the combined therapy group (P = 0.54). X2 testing by pretreatment PSA value, Gleason score sum, risk stratification, isotope and the addition of neoadjuvant hormones failed to identify any group with a significant difference in 5-y PSA-RFS. In conclusion, this retrospective study presents a large cohort of patients treated with PPB that failed to identify a significant advantage for the addition of combined therapy. A matched pair analysis performed also failed to identify any significant difference based on treatment modality. |
| Keywords: | adult; cancer survival; controlled study; aged; aged, 80 and over; disease-free survival; middle aged; survival rate; retrospective studies; major clinical study; androgen; cancer recurrence; monotherapy; multimodality cancer therapy; cancer adjuvant therapy; cancer patient; combined modality therapy; neoadjuvant therapy; cancer staging; follow up; adenocarcinoma; prostate specific antigen; cohort studies; radiotherapy dosage; cohort analysis; retrospective study; risk assessment; prostate cancer; prostate-specific antigen; prostatic neoplasms; iodine 125; scoring system; brachytherapy; antineoplastic agents, hormonal; kaplan meier method; hormone; matched-pair analysis; nomogram; isotope; palladium 103; prostate neoplasm; computer system; humans; human; male; priority journal; article; matched pair analysis; radiothreapy |
| Journal Title: | Prostate Cancer and Prostatic Diseases |
| Volume: | 5 |
| Issue: | 1 |
| ISSN: | 1365-7852 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2002-01-01 |
| Start Page: | 47 |
| End Page: | 53 |
| Language: | English |
| DOI: | 10.1038/sj.pcan.4500552 |
| PUBMED: | 15195130 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 14 November 2014 -- Source: Scopus |
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