Four-year biochemical outcome after radioimmunoguided transperineal brachytherapy for patients with prostate adenocarcinoma.

Abstract

PURPOSE:

To evaluate 4-year biochemical outcomes for patients with prostate adenocarcinoma who underwent radioimmunoguided (Prostascint) permanent prostate brachytherapy.

METHODS AND MATERIALS:

Eighty patients with clinical T1C-T3A NxM0 prostate cancer underwent ProstaScint-guided prostate brachytherapy using either (103)Pd or (125)I between February 1997 and December 2000. Sixty-seven patients underwent prostate brachytherapy alone, whereas 13 patients received neoadjuvant hormonal manipulation before implantation. Risk factors (RF) included PSA >10, Stage >or=T2b, and Gleason grade >or=7. Sixty patients had low-risk disease (0 RF), 17 were intermediate risk (1 RF), and 3 were high risk (2 RF). Biochemical disease-free survival (bDFS) was calculated using the American Society for Therapeutic Radiology and Oncology (ASTRO) consensus criteria, a PSA cutoff of 1.0 ng/mL, and a PSA cutoff of 0.5 ng/mL.

RESULTS:

Four-year bDFS for the entire cohort was 97.4% using the ASTRO consensus criteria. Low-risk patients (60) had a 4-year bDFS of 100%; intermediate- and high-risk patients (20 patients) were 89.2%. The hormonally naïve group (67 patients) had a 4-year bDFS of 96.9% and a median PSA nadir of 0.2 ng/mL. Median time to nadir was 19.8 months (range: 1.9-53.2 months). For the neoadjuvant hormonal therapy group (13 patients), ASTRO-defined bDFS was 100%. Overall, 85.2% of patients had a posttreatment PSA <or=1.0 ng/mL, and 75.9% had a PSA <or=0.5 ng/mL at a median follow-up of 36 months.

CONCLUSIONS:

At a median follow-up of 36 months, ProstaScint-guided transperineal brachytherapy results in a high probability of actuarial 4-year biochemical disease-free survival for patients with localized prostate cancer.

• Authors: Rodney J Ellis, Amy Vertocnik, Edward Kim, Hang Zhou, Benjamin Young, Bruce Sodee, Pingfu Fu, Sam Beddar, Valdir Colussi, John P Spirnak, Kurt H Dinchman, Martin Resnick, Timothy J Kinsella
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 57 Issue 2 Pg. 362-70 (Oct 01 2003) ISSN: 0360-3016 [Print] United States
• PMID: 12957246 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Iodine Radioisotopes
• Radioisotopes
• Palladium
• Prostate-Specific Antigen

Topics

• Adenocarcinoma (blood, mortality, radiotherapy)
• Aged
• Brachytherapy (methods)
• Disease-Free Survival
• Follow-Up Studies
• Humans
• Iodine Radioisotopes (therapeutic use)
• Male
• Middle Aged
• Neoplasm Staging
• Palladium (therapeutic use)
• Prostate-Specific Antigen (blood)
• Prostatic Neoplasms (blood, mortality, radiotherapy)
• Radioimmunodetection
• Radioisotopes (therapeutic use)
• Radiotherapy Dosage
• Time Factors