Ten-year outcomes using low dose rate brachytherapy for localised prostate cancer: An update to the first Australian experience.
- Resource Type
- journal article
- Authors
- Wilson, Craig; Waterhouse, David; Lane, Stephen E; Haworth, Annette; Stanley, John; Shannon, Tom; Joseph, David
- Source
- Journal of Medical Imaging & Radiation Oncology. Aug2016, Vol. 60 Issue 4, p531-538. 8p.
- Subject
- *PROSTATE cancer treatment
*LOW dose rate brachytherapy
*HEALTH outcome assessment
*PROSTATE-specific antigen
*THERAPEUTIC use of iodine
*RADIATION dosimetry
*THERAPEUTICS
- Language
- ISSN
- 1754-9477
Introduction: To report long-term prostate-specific antigen (PSA) and toxicity outcomes for patients with localised prostate cancer treated with Iodine-125 permanent implantation at a single Australian centre.Methods: Between September 1994 and November 2007, 207 patients at Sir Charles Gairdner Hospital with localised prostate cancer were consecutively treated with Iodine-125 permanent interstitial implantation. Post-therapy assessment was performed three times a month and included clinical review and biochemical (PSA) evaluation. PSA progression was evaluated using the Phoenix (nadir + 2.0) definition. Treatment-related morbidity was assessed using the Common Terminology Criteria for Adverse Events (CTCAE) version 3.0 guidelines. The rate of biochemical failure was calculated by Kaplan-Meier plots. Univariate and multivariate analyses were performed to evaluate outcomes by pre-treatment clinical prognostic factors and radiation dosimetry.Results: Median follow-up was 7.8 years. The 10-year biochemical disease-free survival (bDFS) for the entire cohort was 89%. Ten-year bDFS estimates by pre-treatment risk group were 96% for low-risk, 83% for intermediate-risk and 50% for high-risk disease. On multivariate analysis, pre-treatment PSA was an independent predictor of bDFS. D90 dose did not show a statistically significant effect on bDFS. The peak incidences of late grade 3 or higher urinary and rectal toxicities were 10.7% and 1.1% respectively.Conclusion: Excellent long-term biochemical control was demonstrated with Iodine-125 permanent interstitial implantation in appropriately selected patients with prostate cancer. The results of our single centre experience are comparable with those of other single institutions. [ABSTRACT FROM AUTHOR]