Nationwide, Multicenter, Retrospective Study on High-Dose-Rate Brachytherapy as Monotherapy for Prostate Cancer.

Abstract

PURPOSE:

To present, analyze, and discuss results of a nationwide, multicenter, retrospective study on high-dose-rate brachytherapy (HDR-BT) as monotherapy for low-, intermediate-, and high-risk prostate cancer.

METHODS AND MATERIALS:

From 1995 through 2013, 524 patients, 73 (14%) with low-risk, 207 (40%) with intermediate-risk, and 244 (47%) with high-risk prostate cancer, were treated with HDR-BT as monotherapy at 5 institutions in Japan. Dose fractionations were 27 Gy/2 fractions for 69 patients (13%), 45.5 Gy/7 fractions for 168 (32%), 49 Gy/7 fractions for 149 (28%), 54 Gy/9 fractions for 130 (25%), and others for 8 (2%). Of these patients, 156 (30%) did not receive androgen deprivation therapy, and 202 patients (39%) did receive androgen deprivation therapy <1 year, 112 (21%) for 1-3 years, and 54 (10%) for >3 years. Median follow-up time was 5.9 years (range, 0.4-18.1 years), with a minimum of 2 years for surviving patients.

RESULTS:

After 5 years, respective actuarial rates of no biochemical evidence of disease, overall survival, cause-specific survival, and metastasis-free survival for all patients were 92%, 97%, 99%, and 94%. For low/intermediate/high-risk patients, the 5-year no biochemical evidence of disease rates were 95%/94%/89%, the 5-year overall survival rates were 98%/98%/94%, the 5-year cause-specific survival rates were 98%/100%/98%, and the 5-year metastasis-free survival rates were 98%/95%/90%, respectively. The cumulative incidence of late grade 2 to 3 genitourinary toxicity at 5 years was 19%, and that of late grade 3 was 1%. The corresponding incidences of gastrointestinal toxicity were 3% and 0% (0.2%). No grade 4 or 5 of either type of toxicity was detected.

CONCLUSIONS:

The findings of this nationwide, multicenter, retrospective study demonstrate that HDR-BT as monotherapy was safe and effective for all patients with low-, intermediate-, and high-risk prostate cancer.

• Authors: Yasuo Yoshioka, Tadayuki Kotsuma, Akira Komiya, Shinji Kariya, Koji Konishi, Norio Nonomura, Kazuhiko Ogawa, Eiichi Tanaka, Kensaku Nishimura, Yasuyoshi Fujiuchi, Hiroshi Kitamura, Takuji Yamagami, Ichiro Yamasaki, Kazuo Nishimura, Teruki Teshima, Katsumasa Nakamura, Jun Itami
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 97 Issue 5 Pg. 952-961 (04 01 2017) ISSN: 1879-355X [Electronic] United States
• PMID: 28333018 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2016 Elsevier Inc. All rights reserved.

Topics

• Aged
• Aged, 80 and over
• Brachytherapy (mortality, statistics & numerical data)
• Disease-Free Survival
• Dose Fractionation, Radiation
• Gastrointestinal Diseases (mortality, prevention & control)
• Humans
• Japan (epidemiology)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (mortality, prevention & control)
• Prevalence
• Prostatic Neoplasms (mortality, radiotherapy)
• Radiation Injuries (mortality, prevention & control)
• Retrospective Studies
• Risk Factors
• Survival Rate
• Treatment Outcome