PURPOSE: To report survival and morbidity of a cohort of 200 hormone-naïve consecutive patients with localized prostate cancer, treated by low-dose rate brachytherapy within the frame of multidisciplinary approach.
PATIENTS AND METHODS: Between 2001 and 2011, 200 patients were treated by the same team with 125 iodine seeds: 167 low-risk and 33 intermediate risk according to the d'Amico classification; eligible patients had clinical stage T1/T2a-b, Gleason score 3+3 or 3+4, baseline prostate-specific antigen level below 15ng/mL, prostate volume less than 60cm3. The median number of random biopsies was 12 (range 6-32) and the breakdown of positive cores was as follows: 1 (29%), 2 (35%), 3 or more (36%). Acute morbidity was assessed according to the Common Terminology Criteria for Adverse Events and late toxicity according to the EORTC/RTOG scale. Data were prospectively collected.
RESULTS: The median follow-up was 69months (range 16 to 135). The 5- and 10-year biochemical relapse free survivals were 95.6% (95% confidence interval [CI]: 91-98) and 89.7% (95% CI: 79.4-95.0). The 5-year and 10-year overall survival were respectively 96.4% (95% CI: 92-98.4) and 89.7% (95% CI: 80.8-94.6%) and the 10-year disease specific survival, 99.1% (95% CI: 93.0-99.9). The 5- and 10-year grade 3 acute toxicity cumulative rate were respectively 3.3% (95% CI: 1.4-6.6) and 4% (95% CI: 1.4-6.6) and the 5- and 10-year grades 3 cumulative late toxicity 2.5% (95% CI: 2.0-5.9) and 4% (95% CI: 2.0-5.9).
CONCLUSION: Brachytherapy managed within the frame of a multidisciplinary approach - from diagnosis to evaluation - may offer optimized results with a reduced late toxicity rate, while remaining opened to dosimetry and technical improvements.
Bolla M, Verry C, Giraud JY, Long JA, Conil M, Abidi R, Troccaz J, Colonna M, Descotes JL. Are you the author?
Département d'oncologie-radiothérapie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France; Département d'urologie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France; Équipe GMCAO, Laboratoire TIMC-IMAG, université Joseph-Fourier, Domaine de la Merci, 38706 La Tronche cedex, France; CNRS UMR 5525, domaine de la Merci, 38706 La Tronche cedex, France; Registre des cancers de l'Isère, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France.
Reference: Cancer Radiother. 2014 Oct 3. pii: S1278-3218(14)00344-8.