Long-term results of permanent implant prostate cancer brachytherapy: A single-institution study of 675 patients treated between 1999 and 2003.

To analyse long-term overall survival, relapse-free survival and late toxicities in a series of 675 patients treated between 1999 and 2003, with a median follow-up of 132 months.

The cohort included low-risk patients and a selection of "favourable-intermediate" risk patients. All patients were homogeneously treated using an intraoperative dynamic planning prostate brachytherapy technique, with loose 125 iodine seeds. Hormone therapy, consisting most often of an anti-androgen alone, was given in 393 patients (58%).

The 10-year overall survival was 92% (95% confidence interval [CI]: 90-94) without a significant difference between the low and the select intermediate-risk groups (P=0.17). The 10-year relapse-free survival rate for the entire cohort was 82% (95% CI: 79-85), and was significantly higher in the low-risk group than in the intermediate one (87 vs 71%; P<0.0001). Twenty-six percent of the relapses observed in this series occurred after more than 10 years of follow-up. The 10-year cumulative incidence of grade 3-4 urinary toxicity (whatever the delay and the recovery) was 5.78%. The cumulative incidence of grades 3-4 rectal toxicity in the present series was 1.65% at 10 years. As for sexual toxicity, 61% of our patients retained an erectile capacity at 10 years (with or without oral medication), with age being a major factor.

With a median follow-up of more than 11 years, this series appears to confirm the excellent long-term results of low-dose rate prostate brachytherapy, both in terms of survival and in terms of toxicity.

Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique. 2016 Jun 15 [Epub ahead of print]

J-M Cosset, T Flam, L Belin, N Thiounn, N Pierrat, D Pontvert, G Wakil, A Savignoni, L Chauveinc

Institut Curie, 26, rue d'Ulm, 75005 Paris, France; Centre de radiothérapie Charlebourg-La-Défense, groupe Amethyst, 65, avenue Foch, 92250 La Garenne-Colombes, France. Electronic address: ., Institut Curie, 26, rue d'Ulm, 75005 Paris, France; Fondation Saint-Jean-de-Dieu-Oudinot, 19, rue Oudinot, 75007 Paris, France., Institut Curie, 26, rue d'Ulm, 75005 Paris, France., Hôpital européen Georges-Pompidou, 20, rue Leblanc, 75015 Paris, France., Institut Curie, 26, rue d'Ulm, 75005 Paris, France., Institut Curie, 26, rue d'Ulm, 75005 Paris, France., Institut Curie, 26, rue d'Ulm, 75005 Paris, France; Charles Lemoyne Hospital, 3120, boulevard Taschereau, Greenfield Park, J4V 2H1 Montréal, QC, Canada., Institut Curie, 26, rue d'Ulm, 75005 Paris, France., Institut Curie, 26, rue d'Ulm, 75005 Paris, France; Centre de radiothérapie Hartmann, 4, rue Kléber, 93200 Levallois-Perret, France.