Abstract
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.
| Original language | English |
|---|---|
| Article number | 20150981 |
| Journal | British Journal of Radiology |
| Volume | 89 |
| Issue number | 1065 |
| DOIs | |
| Publication status | Published - 2016 |
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ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
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Low dose rate brachytherapy (LDR-BT) as monotherapy for early stage prostate cancer in Italy : Practice and outcome analysis in a series of 2237 patients from 11 institutions. / Fellin, Giovanni; Mirri, Maria A.; Santoro, Luigi; Jereczek, Barbara Alicja; Divan, Claudio; Mussari, Salvatore; Ziglio, Francesco; La Face, Beniamino; Barbera, Fernando; Buglione, Michela; Bandera, Laura; Ghedi, Barbara; Di Muzio, Nadia G.; Losa, Andrea; Mangili, Paola; Nava, Luciano; Chiarlone, Renato; Ciscognetti, Nunzia; Gastaldi, Emilio; Cattani, Federica; Spoto, Ruggero; Vavassori, Andrea; Giglioli, Francesca R.; Guarneri, Alessia; Cerboneschi, Valentina; Mignogna, Marcello; Paoluzzi, Mauro; Ravaglia, Valentina; Chiumento, Costanza; Clemente, Stefania; Fusco, Vincenzo; Santini, Roberto; Stefanacci, Marco; Mangiacotti, Francesco P.; Martini, Marco; Palloni, Tiziana; Schinaia, Giuseppe; Lazzari, Grazia; Silvano, Giovanni; Magrini, Stefano; Ricardi, Umberto; Santoni, Riccardo; Orecchia, Roberto.
In: British Journal of Radiology, Vol. 89, No. 1065, 20150981, 2016.Research output: Contribution to journal › Article
}
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.
UR - http://www.scopus.com/inward/record.url?scp=84989912722&partnerID=8YFLogxK
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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 -