OBJECTIVES: To evaluate the interim outcomes of low-dose-rate permanent brachytherapy (PB) combined with short-term androgen deprivation therapy (ADT) in Japanese men with intermediate-risk prostate cancer excluding those with a Gleason score of 4+3.
METHODS: The Protocol-intermediate-risk group (Protocol-IRG) was defined as clinical stage T1c-T2c, Gleason score of 3+4, or lower and prostatic-specific antigen (PSA) level lower than 20ng/mL. A total of 308 patients underwent brachytherapy in the protocol-IRG group (n=152) or in the low-risk group (n=156). Patients in Protocol-IRG had received at least 6 months of ADT before and after PB. Supplemental external beam radiotherapy was not used. Planned followup by PSA was carried out every 3 months for the first 2 years and every 6 months thereafter. The PSA failure was defined as nadir+2ng/mL. Patients' Expanded Prostate Cancer Index Composite was recorded before and 3 years after treatment.
RESULTS: The median followup was 68 and 68 months for the protocol-IRG and the low-risk groups, respectively. The 5-year biological disease-free survival rates in the low-risk and protocol-IRG groups were 94.8 and 94.6%, respectively. As far as survival rates were concerned, there were no significant differences between the two groups. Overall satisfaction and sexual function at 3 years after PB had significantly improved compared with pretreatment (p=0.01 and p=0.01, respectively).
CONCLUSIONS: In intermediate-risk prostate patients, excluding those with a biopsy Gleason score of 4+3, brachytherapy with short-term ADT can be an effective treatment option for Japanese men.
Yamada Y, Masui K, Iwata T, Naitoh Y, Yamada K, Miki T, Okihara K. Are you the author?
Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Reference: Brachytherapy. 2014 Oct 8. pii: S1538-4721(14)00643-6.