Outcomes of Gleason Score < or =8 among High Risk Prostate Cancer Treated with 125I Low Dose Rate Brachytherapy Based Multimodal Therapy.
10.3349/ymj.2013.54.5.1207
- Author:
Dong Soo PARK
1
;
In Hyuck GONG
;
Don Kyung CHOI
;
Jin Ho HWANG
;
Hyun Soo SHIN
;
Jong Jin OH
Author Information
1. Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea. bebsuzzang@naver.com
- Publication Type:Original Article
- Keywords:
Prostate cancer;
brachytherapy;
high risk group;
biochemical recurrence
- MeSH:
Aged;
Combined Modality Therapy;
Humans;
Male;
Middle Aged;
Multivariate Analysis;
Neoplasm Grading;
Prostatic Neoplasms/pathology/*radiotherapy;
Radiation Dosage;
Regression Analysis;
Retrospective Studies;
Treatment Outcome
- From:Yonsei Medical Journal
2013;54(5):1207-1213
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To investigate the role of low dose rate (LDR) brachytherapy-based multimodal therapy in high-risk prostate cancer (PCa) and analyze its optimal indications. MATERIALS AND METHODS: We reviewed the records of 50 high-risk PCa patients [clinical stage > or =T2c, prostate-specific antigen (PSA) >20 ng/mL, or biopsy Gleason score > or =8] who had undergone 125I LDR brachytherapy since April 2007. We excluded those with a follow-up period <3 years. Biochemical recurrence (BCR) followed the Phoenix definition. BCR-free survival rates were compared between the patients with Gleason score > or =9 and Gleason score < or =8. RESULTS: The mean initial PSA was 22.1 ng/mL, and mean D90 was 244.3 Gy. During a median follow-up of 39.2 months, biochemical control was obtained in 72% (36/50) of the total patients; The estimated 3-year BCR-free survival was 92% for the patients with biopsy Gleason scores < or =8, and 40% for those with Gleason scores > or =9 (p<0.001). In Cox multivariate analysis, only Gleason score > or =9 was observed to be significantly associated with BCR (p=0.021). Acute and late grade > or =3 toxicities were observed in 20% (10/50) and 36% (18/50) patients, respectively. CONCLUSION: Our results showed that 125I LDR brachytherapy-based multimodal therapy in high-risk PCa produced encouraging relatively long-term results among the Asian population, especially in patients with Gleason score < or =8. Despite small number of subjects, biopsy Gleason score > or =9 was a significant predictor of BCR among high risk PCa patients after brachytherapy.
