Radical prostatectomy versus high dose permanent prostate brachytherapy using iodine-125 seeds for patients with high risk prostate cancer: A matched cohort analysis - Abstract

OBJECTIVE: To compare the biochemical outcomes reported after radical prostatectomy (RP) versus high dose permanent prostate brachytherapy (HDPPB) using iodine-125 seeds in the treatment of matched high risk prostate cancer (HiPCa).

METHODS: In this retrospective review, 55 HiPCa patients treated between March 2006 and August 2011, who underwent HDPPB using iodine-125 seeds combined with external beam radiation therapy (EBRT) or androgen deprivation therapy (ADT), were compared with 55 HiPCa patients who underwent RP. Patients were matched for age, prostate-specific antigen (PSA), clinical stage, and Gleason scores. The biochemical outcomes after HDPPB and RP were compared via Kaplan-Meier analysis.

RESULTS: Of the 110 patients analyzed, the mean ages, PSA, and Gleason biopsy scores were similar between the two cohorts. Among patients who underwent HDPPB, 20 patients (36.4 %) had received adjuvant EBRT. Of this subsample, most patients (98.2 %) had received adjuvant ADT for 3 months. Among patients with RP, 20 patients (36.4 %) had received adjuvant EBRT, whereas 28 patients had received adjuvant ADT. The mean implanted seed numbers were 92.8, the mean D90 was 218.7 Gy, and the mean V100 was 96.1 % after HDPPB. With regard to oncological outcomes, biochemical disease-free survival rates were similar between the two cohorts (82.6 vs. 81.1 %, p = 0.982). Urethrorectal fistula developed in one patient with HDPPB.

CONCLUSION: RP and HDPPB, using iodine-125 seeds with combined treatment modalities, exhibited similar biochemical recurrence-free survival rates among HiPCa patients. Further prospective studies with greater sample sizes and longer follow-up periods are needed to validate these results.

Written by:
Park DS, Gong IH, Choi DK, Hwang JH, Shin HS, Oh JJ.   Are you the author?
Department of Urology, CHA Bundang Medical Center, CHA University, 351 yatap-dong, Bundang-gu, Seongnam-si, 463-712, Korea.

Reference: World J Urol. 2013 Apr 27. Epub ahead of print.
doi: 10.1007/s00345-013-1086-3

PubMed Abstract
PMID: 23624718

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