To evaluate the oncological and functional outcomes of young men treated with low-dose-rate brachytherapy (BT) for prostate cancer (PCa).
423 men aged ≤60 years with clinically localized PCa were treated with BT ± external beam radiation. Biochemical failure was defined by Phoenix criteria. Freedom from biochemical failure (FFbF) and cancer-specific survival (CSS) at 10 and 15 years were estimated by the Kaplan-Meier method with the log-rank test to compare outcomes between National Comprehensive Cancer Network risk groups. The Cox proportional hazards model was used to determine significant predictors for FFbF and CSS.
Median followup was 9.9 years (range, 5.1-21.7). Median age was 57 years (range, 39-60), and median prostate-specific antigen was 6.1 ng/mL (range, 0.8-71). Overall, 10- and 15-year FFbF rates were 89% and 88%; 10- and 15-year CSS rates were 99% and 98%. Increasing disease risk was associated with lower FFbF and CSS (p < 0.0001). Biologically effective dose (p < 0.0001) and use of external beam radiation (p = 0.005) were significantly associated with higher FFbF. In men potent before BT, 64% (151/237) had preserved erectile function at a median 10.2 years. There was no significant difference between treatment groups with respect to long-term urinary function (p = 0.56).
Younger men treated with BT experience excellent long-term PCa control with low rates of treatment-related toxicity.
Brachytherapy. 2019 Jan 08 [Epub ahead of print]
Jared S Winoker, Olamide O Omidele, Richard G Stock, Nelson N Stone
Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY., Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY., Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY. Electronic address: .