Nationwide multicenter retrospective study on high-dose-rate brachytherapy as monotherapy for prostate cancer

Publication date: Available online 18 December 2016
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Yasuo Yoshioka, Tadayuki Kotsuma, Akira Komiya, Shinji Kariya, Koji Konishi, Norio Nonomura, Kazuhiko Ogawa, Eiichi Tanaka, Kensaku Nishimura, Yasuyoshi Fujiuchi, Hiroshi Kitamura, Takuji Yamagami, Ichiro Yamasaki, Kazuo Nishimura, Teruki Teshima, Katsumasa Nakamura, Jun Itami
PurposeTo present, analyze and discuss results of a nationwide multicenter retrospective study on high-dose-rate brachytherapy (HDR-BT) as monotherapy for low-, intermediate- and high-risk prostate cancer.Methods and materialsFrom 1995 through 2013, 524 patients, 73 (14%) with low-risk, 207 (40%) with intermediate-risk, and 244 (47%) with high-risk prostate cancer, were treated with HDR-BT as monotherapy at 5 institutions in XXXXX. Dose fractionations were 27 Gy/2 fractions for 69 patients (13%), 45.5 Gy/7 fractions for 168 (32%), 49 Gy/7 fractions for 149 (28%), 54 Gy/9 fractions for 130 (25%), and others for 8 (2%). Of these patients, 156 (30%) did not receive androgen deprivation therapy (ADT), 202 patients (39%) did receive ADT <1 year, 112 (21%) for 1-3 years, and 54 (10%) for >3 years. Median follow-up time was 5.9 years (range, 0.4-18.1 years), with a minimum of 2 years for surviving patients.ResultsAfter 5 years, respective actuarial rates of no biochemical evidence of disease (bNED), overall survival (OS), cause-specific survival (CSS), and metastasis-free survival (MFS) for all patients were 92%, 97%, 99%, and 94%. For low/intermediate/high-risk patients, the 5-year bNED rates were 95%/94%/89%, the 5-year OS rates were 98%/98%/94%, the 5-year CSS rates were 98%/100%/98%, and the 5-year MFS rates were 98%/95%/90%, respectively. The cumulative incidence of late Grade 2-3 genitourinary toxicity at 5 years was 19%, and that of late Grade 3 was 1%. The corresponding incidences of gastrointestinal toxicity were 3% and 0% (0.2%). No Grade 4 or 5 of either type of toxicity was detected.ConclusionsThe findings of this nationwide multicenter retrospective study demonstrate that HDR-BT as monotherapy was safe and effective for all patients with low-, intermediate- and high-risk prostate cancer.

Teaser

A nationwide multicenter retrospective study on high-dose-rate brachytherapy (HDR-BT) as monotherapy for prostate cancer was conducted. A total of 524 patients was treated at 5 institutions in Japan. Median follow-up time was 5.9 years. For low/intermediate/high-risk patients, 5-year rates for no biochemical evidence of disease were 95%/94%/89%, respectively. Late Grade 3 genitourinary/gastrointestinal toxicity rate was 1%/0.2% at 5 years. This study thus demonstrated that HDR-BT monotherapy was safe and effective for patients with prostate cancer.


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