A retrospective analysis after low-dose-rate prostate brachytherapy with permanent 125I seed implant: Clinical and dosimetric results in 70 patients

Costanza Chiumento, Antonietta Montagna, Stefania Clemente, Mariella Cozzolino, Vincenzo Fusco

Research output: Contribution to journalArticle

Abstract

Aims and background. To evaluate the biochemical disease-free survival (bDFS) rate after 125I permanent-implant prostate brachytherapy. Methods. Patients with a diagnosis of prostate adenocarcinoma and adequate PSA follow-up were selected for this retrospective study. Brachytherapy with permanent 125I seeds was performed as monotherapy, with a prescribed dose of 145 Gy to the prostate. Patients were stratified into recurrence risk groups according to the National Comprehensive Cancer Network (NCCN) guidelines. Biochemical failure was defined using the American Society of Therapeutic Radiology and Oncology (ASTRO) guidelines. The post-implant D90 (defined as the minimum dose covering 90% of the prostate) was obtained for each patient. Two cutoff points were used to test the correlation between D90 and bDFS results: 130 Gy and 140 Gy. bDFS was calculated from the implant date to the date of biochemical recurrence. Univariate and multivariate analysis were performed using the SPSS software and included clinical stage, pretreatment PSA, Gleason score (GS), androgen deprivation therapy, D90, and risk groups. In the univariate analysis we used a cutoff point of 5.89 ng/mL for PSA and 5 for GS. Results. From June 2003 to April 2007, 70 patients were analyzed. The patients' distribution into recurrence risk groups was as follows: 39 patients (56%) in the low-risk group, 23 patients (33%) in the intermediate-risk group, and 8 patients (11%) in the high-risk group. At a median follow-up of 47 months (range, 19-70 months) bDFS was 88.4%, with a global actuarial 5-year bDFS of 86%. Disease-related factors including initial PSA level, GS and risk group were significant predictors of biochemical failure (P = 0.01, P = 0.01, P = 0.006, respectively). In multivariate analysis, risk group (P = 0.005) and GS (P = 0.03) were statistically significant. Conclusion. Our data are in agreement with those in the literature and, despite the short follow-up, confirm the advantage of brachytherapy for patients at low and intermediate risk of recurrence.

Original languageEnglish
Pages (from-to)335-340
Number of pages6
JournalTumori
Volume97
Issue number3
DOIs
Publication statusPublished - May 2011

Keywords

  • Biochemical disease-free survival
  • Prostate brachytherapy
  • Prostate-specific antigen
  • Risk groups

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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