Brachytherapy Improves Biochemical Failure–Free Survival in Low- and Intermediate-Risk Prostate Cancer Compared With Conventionally Fractionated External Beam Radiation Therapy: A Propensity Score Matched Analysis

2015 ◽  
Vol 91 (3) ◽  
pp. 505-516 ◽  
Author(s):  
Graham D. Smith ◽  
Tom Pickles ◽  
Juanita Crook ◽  
Andre-Guy Martin ◽  
Eric Vigneault ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
External Beam Radiation Therapy ◽  
Biochemical Failure ◽  
External Beam Radiation ◽  
External Beam ◽  
Intermediate Risk ◽  
Beam Radiation ◽  
Free Survival ◽  
Risk Prostate Cancer ◽  
Conventionally Fractionated

Ten year treatment outcomes of radical prostatectomy vs external beam radiation therapy vs. brachytherapy for 1,503 patients with intermediate risk prostate cancer.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 47-47 ◽  
Author(s):  
Barry W. Goy ◽  
Margaret S. Soper ◽  
Raoul J. Burchette ◽  
Tangel C. Chang ◽  
Harry A. Cosmatos
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
External Beam Radiation Therapy ◽  
Biochemical Failure ◽  
External Beam Radiation ◽  
External Beam ◽  
Intermediate Risk ◽  
Beam Radiation ◽  
Risk Prostate Cancer ◽  
Iodine 125

47 Background: To compare 10-year treatment outcomes of RP (radical prostatectomy) vs EBRT (external beam radiation therapy) vs BT (brachytherapy) for patients with IRPC (intermediate risk prostate cancer). Methods: A retrospective analysis using propensity score matching was performed on 1,503 IRPC patients who underwent treatment from 2004 to 2007. 819 underwent RP, 574 underwent EBRT to a median dose of 75.3 Gray, and 110 underwent BT using iodine-125. Biochemical failure was defined by the AUA (American Urological Association) definition of PSA (prostate specific antigen) failure for RP patients, and the ASTRO-Phoenix definition (American Society of Therapeutic Radiology and Oncology) for the EBRT and BT patients. Results: Median follow up was 10 years for RP, 9.6 for EBRT, and 9.8 for BT (range 1-13.4 years). With RP 76.3% had Gleason score 7 vs 72.8% for EBRT vs 57.3% for BT, p = 0.0001. Median initial PSA was 7.4 for RP, 9.4 for EBRT, and 8.3 for BT, p < 0.0001. Neoadjuvant androgen deprivation therapy was given in 58.9% of EBRT patients vs 12.7% of BT vs 0.6% for RP, p < 0.0001. Only 14% of BT received supplemental external radiation. The 10-year FFBF (freedom from biochemical failure) was 82.0% for BT vs 58.0% for RP vs 58.8% for EBRT, p < 0.0001. Subset analysis of unfavorable IRPC patients showed a 10 year FFBF of 81.6% for BT vs 55.8% for RP vs 51.0% for EBRT, p < 0.0001. The 10-year freedom from salvage therapy was 89.5% for BT vs 64.0% for RP vs 73.4% for EBRT, p < 0.0001. There were no significant differences in distant metastases-free survival, prostate cancer-specific survival, or overall survival after adjusting for age. Multivariate analysis between pairwise groups with BT balanced by stabilized inverse probability of treatment weights showed that BT remained an independent predictor for improved FFBF, p = 0.049 for BT vs EBRT, and p < 0.0001 for BT vs RP. Conclusions: Brachytherapy using iodine-125 is a reasonable treatment option for IRPC patients. Although BT showed improved FFBF after propensity score matching, this did not impact overall survival.

Treatment results of brachytherapy versus external beam radiation therapy for intermediate risk prostate cancer.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. e16041-e16041
Author(s):  
Barry W. Goy ◽  
Margaret S. Soper ◽  
Tangel Chang ◽  
Harry A. Cosmatos ◽  
Jeff M. Slezak ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
External Beam Radiation Therapy ◽  
External Beam Radiation ◽  
External Beam ◽  
Intermediate Risk ◽  
Treatment Results ◽  
Beam Radiation ◽  
Risk Prostate Cancer

scholarly journals Assessing the Optimum Use of Androgen-Deprivation Therapy in High-Risk Prostate Cancer Patients Undergoing External Beam Radiation Therapy

2016 ◽  
Vol 11 (1) ◽  
pp. 73-81 ◽  
Author(s):  
Michelle S. Ludwig ◽  
Deborah A. Kuban ◽  
Sara S. Strom ◽  
Xianglin L. Du ◽  
David S. Lopez ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Distant Metastasis ◽  
External Beam Radiation Therapy ◽  
Biochemical Failure ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer

The optimum use of androgen deprivation therapy (ADT) in high-risk prostate cancer patients has not been defined in the setting of dose-escalated external beam radiation therapy. A retrospective analysis of 1,290 patients with high-risk prostate cancer from June 1987 through March 2010 treated with external beam radiation therapy was performed. Median follow-up was 7.2 years, and 797 patients received ADT, with 384 patients experiencing a biochemical failure and 145 with distant metastasis. ADT was associated with lower risk of biochemical failure and distant metastasis than no ADT after adjusting for age, prostate-specific antigen (PSA), Gleason score, year of diagnosis, tumor stage, and radiation dose. ADT was associated with a greater reduction in biochemical failure in the low-dose radiation group than in the high-dose group. Patients with >24 months of ADT had a lower risk of PSA failures than those with <24 months. ADT was associated with decreased risk of biochemical failure and distant metastasis in all patients. The effect of ADT on reducing risk of biochemical failure was greater among men with low-dose radiation. There was a benefit in PSA and distant metastasis-free survival with >24 months of ADT in all patients who received ADT.

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