Title | Prospective Phase 2 Trial of Permanent Seed Implantation Prostate Brachytherapy for Intermediate-Risk Localized Prostate Cancer: Efficacy, Toxicity, and Quality of Life Outcomes. |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Frank SJ, Pugh TJ, Blanchard P, Mahmood U, Graber WJ, Kudchadker RJ, Davis JW, Kim J, Choi H, Troncoso P, Kuban DA, Choi S, McGuire S, Hoffman KE, Chen H-C, Wang X, Swanson DA |
Journal | Int J Radiat Oncol Biol Phys |
Volume | 100 |
Issue | 2 |
Pagination | 374-382 |
Date Published | 2018 Feb 01 |
ISSN | 1879-355X |
Abstract | PURPOSE: To report the efficacy, physician-reported toxicity, and patient-reported outcomes of men with intermediate-risk prostate cancer after brachytherapy in a prospective phase 2 trial. METHODS AND MATERIALS: This prospective phase 2 trial involved 300 patients with previously untreated prostate cancer treated from 2006 through 2013. Eligible patients had ≤cT2b (T3 excluded according to magnetic resonance imaging), Gleason score (GS) 6 with prostate-specific antigen (PSA) level 10-15 ng/mL, or GS 7 with PSA <10 ng/mL, and were treated with prostate brachytherapy (without hormonal therapy). RESULTS: Median patient age was 64.9 years; 3.7% had GS 6, 78.7% had GS 7 (3+4), and 17.7% had GS 7 (4+3). Median follow-up time was 5.1 years. Median PSA at 5 years was 0.01 ng/mL (range, 0-6.0 ng/mL). Ten biochemical failures occurred, for a 5-year freedom from biochemical failure rate of 97.3% (95% confidence interval [CI], 95.1-99.5), and 16 patients died, only 1 from prostate cancer, for 5-year rates of overall and biochemical progression-free survival of 94.9% (95% CI, 92.1-97.9) and 92.7% (95% CI, 89.3-96.2%). Four patients had late grade 3 genitourinary toxicity, and 2 patients had late grade 3 rectal toxicity; no grade 4 or 5 toxicity was observed. Rates of "moderate or big problems" at 4 years were 7.4% for urinary (vs 0.4% at baseline), 2.9% bowel (vs 0.4%), and 29.7% sexual function (vs 19.7%). Most men were "satisfied or extremely satisfied" (91% at 2 years after treatment and 93% at 4 years). CONCLUSIONS: Brachytherapy monotherapy is safe and effective and leads to good quality of life for some men with localized intermediate-risk prostate cancer. |
DOI | 10.1016/j.ijrobp.2017.09.050 |
Alternate Journal | Int. J. Radiat. Oncol. Biol. Phys. |
PubMed ID | 29229325 |
Submitted by kej2006 on June 6, 2018 - 4:13pm