TY - JOUR
T1 - Low dose rate brachytherapy (LDR-BT) as monotherapy for early stage prostate cancer in Italy
T2 - Practice and outcome analysis in a series of 2237 patients from 11 institutions
AU - Fellin, Giovanni
AU - Mirri, Maria A.
AU - Santoro, Luigi
AU - Jereczek, Barbara Alicja
AU - Divan, Claudio
AU - Mussari, Salvatore
AU - Ziglio, Francesco
AU - La Face, Beniamino
AU - Barbera, Fernando
AU - Buglione, Michela
AU - Bandera, Laura
AU - Ghedi, Barbara
AU - Di Muzio, Nadia G.
AU - Losa, Andrea
AU - Mangili, Paola
AU - Nava, Luciano
AU - Chiarlone, Renato
AU - Ciscognetti, Nunzia
AU - Gastaldi, Emilio
AU - Cattani, Federica
AU - Spoto, Ruggero
AU - Vavassori, Andrea
AU - Giglioli, Francesca R.
AU - Guarneri, Alessia
AU - Cerboneschi, Valentina
AU - Mignogna, Marcello
AU - Paoluzzi, Mauro
AU - Ravaglia, Valentina
AU - Chiumento, Costanza
AU - Clemente, Stefania
AU - Fusco, Vincenzo
AU - Santini, Roberto
AU - Stefanacci, Marco
AU - Mangiacotti, Francesco P.
AU - Martini, Marco
AU - Palloni, Tiziana
AU - Schinaia, Giuseppe
AU - Lazzari, Grazia
AU - Silvano, Giovanni
AU - Magrini, Stefano
AU - Ricardi, Umberto
AU - Santoni, Riccardo
AU - Orecchia, Roberto
PY - 2016
Y1 - 2016
N2 - Objective: Low-dose-rate brachytherapy (LDR-BT) in localized prostate cancer is available since 15 years in Italy. We realized the first national multicentre and multidisciplinary data collection to evaluate LDR-BT practice, given as monotherapy, and outcome in terms of biochemical failure. Methods: Between May 1998 and December 2011, 2237 patients with early-stage prostate cancer from 11 Italian community andacademic hospitals were treated with iodine- 125 (125I) or palladium-103 LDR-BT as monotherapy and followed up for at least 2 years. 125I seeds were implanted in 97.7% of the patients: the mean dose received by 90% of target volume was 145Gy; the mean target volume receiving 100% of prescribed dose (V100) was 91.1%. Biochemical failurefree survival (BFFS), disease-specific survival (DSS) and overall survival (OS) were estimated using Kaplan-Meier method. Log-rank test and multivariable Cox regression were used to evaluate the relationship of covariates with outcomes. Results: Median follow-up time was 65 months. 5- and 7-year DSS, OS and BFFS were 99 and 98%, 94 and 89%, and 92 and 88%, respectively. At multivariate analysis, the National Comprehensive Cancer Network score (p<0.0001) and V100 (p=0.09) were correlated with BFFS, with V100 effect significantly different between patients at low risk and those at intermediate/high risk (p=0.04). Short follow-up and lack of toxicity data represent the main limitations for a global evaluation of LDR-BT. Conclusion: This first multicentre Italian report confirms LDR-BT as an excellent curative modality for low-/intermediate-risk prostate cancer. Advances in knowledge: Multidisciplinary teams may help to select adequately patients to be treated with brachytherapy, with a direct impact on the implant quality and, possibly, on outcome.
AB - Objective: Low-dose-rate brachytherapy (LDR-BT) in localized prostate cancer is available since 15 years in Italy. We realized the first national multicentre and multidisciplinary data collection to evaluate LDR-BT practice, given as monotherapy, and outcome in terms of biochemical failure. Methods: Between May 1998 and December 2011, 2237 patients with early-stage prostate cancer from 11 Italian community andacademic hospitals were treated with iodine- 125 (125I) or palladium-103 LDR-BT as monotherapy and followed up for at least 2 years. 125I seeds were implanted in 97.7% of the patients: the mean dose received by 90% of target volume was 145Gy; the mean target volume receiving 100% of prescribed dose (V100) was 91.1%. Biochemical failurefree survival (BFFS), disease-specific survival (DSS) and overall survival (OS) were estimated using Kaplan-Meier method. Log-rank test and multivariable Cox regression were used to evaluate the relationship of covariates with outcomes. Results: Median follow-up time was 65 months. 5- and 7-year DSS, OS and BFFS were 99 and 98%, 94 and 89%, and 92 and 88%, respectively. At multivariate analysis, the National Comprehensive Cancer Network score (p<0.0001) and V100 (p=0.09) were correlated with BFFS, with V100 effect significantly different between patients at low risk and those at intermediate/high risk (p=0.04). Short follow-up and lack of toxicity data represent the main limitations for a global evaluation of LDR-BT. Conclusion: This first multicentre Italian report confirms LDR-BT as an excellent curative modality for low-/intermediate-risk prostate cancer. Advances in knowledge: Multidisciplinary teams may help to select adequately patients to be treated with brachytherapy, with a direct impact on the implant quality and, possibly, on outcome.
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U2 - 10.1259/bjr.20150981
DO - 10.1259/bjr.20150981
M3 - Article
AN - SCOPUS:84989912722
VL - 89
JO - British Journal of Radiology
JF - British Journal of Radiology
SN - 0007-1285
IS - 1065
M1 - 20150981
ER -