External radiotherapy and permanent prostate brachytherapy in patients with localized prostate cancer Journal Article
| Authors: | Potters, L.; Fearn, P.; Kattan, M. W. |
| Article Title: | External radiotherapy and permanent prostate brachytherapy in patients with localized prostate cancer |
| Abstract: | We examined the difference in prostate-specific antigen (PSA)-freedom from recurrence (FFR) in patients with localized prostate cancer treated with permanent prostate brachytherapy (PPB) alone or external radiotherapy combined with PPB (RT-PPB). A total of 1476 patients with prostate cancer (T1/T2) were treated with PPB by following the American Brachytherapy Society criteria. Patient self-selection and preference allowed for an overlap of treatment methodologies and risk factors. Monotherapy consisted of 125I or 103Pd. RT-PPB consisted of RT followed by PPB. PSA-FFR was based on a published modification of the American Society for Therapeutic Radiology and Oncology definition. Cox regression analysis was performed to assess the role of Gleason sum, pretreatment PSA value, clinical stage, RT-PPB, the addition of hormones, and the minimum dose covering 90% of the prostate volume (D90 dose). Monotherapy was used for 1016 patients (79%), and RT-PPB was used for 281 patients (21%), with an overall 6-year PSA-FFR of 83.2% (median follow-up of 34.7 months; range, 6-91 months). Multivariate Cox regression analysis to predict PSA-FFR identified the following highly significant variables: pretreatment PSA value, Gleason sum, and the addition of hormones. When the D90% (D90 dose relative to the prescribed dose) was included as a variable, Cox regression identified only the following significant variables: D90%, pretreatment PSA, and Gleason sum. Cox regression failed to identify an improvement in PSA-FFR with RT-PPB or the addition of hormones. Although these conclusions question the role for RT-PPB, only a comparative trial will be able to answer this question definitively. © 2002 Elsevier Science Inc. All rights reserved. |
| Keywords: | adult; controlled study; aged; aged, 80 and over; middle aged; major clinical study; cancer recurrence; cancer patient; cancer radiotherapy; radiation dose; follow up; adenocarcinoma; prostate specific antigen; demography; tumor volume; radiotherapy; risk factor; prostatic neoplasms; statistical significance; iodine 125; brachytherapy; multivariate logistic regression analysis; matched-pair analysis; nomogram; palladium 103; prostate carcinoma; prostate neoplasm; interstitial radiation; humans; human; male; priority journal; article |
| Journal Title: | Brachytherapy |
| Volume: | 1 |
| Issue: | 1 |
| ISSN: | 1538-4721 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2002-01-01 |
| Start Page: | 36 |
| End Page: | 41 |
| Language: | English |
| DOI: | 10.1016/s1538-4721(02)00008-9 |
| PUBMED: | 15062185 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 14 November 2014 -- Source: Scopus |
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