125I low-dose-rate prostate brachytherapy and radical prostatectomy in patients with prostate cancer.

Abstract

Radical prostatectomy (RP) and low-dose-rate prostate brachytherapy (LDR) are two widely used treatment options for patients with T1c-T3a prostate cancer. In the present study, the efficacy of the two treatments was compared. A total of 429 patients who underwent either LDR (n=218) or RP (n=211) between January 2010 and June 2015 were retrospectively reviewed. Biochemical relapse-free survival time (bRFS) and clinical relapse-free survival time (cRFS) were assessed. The log-rank test compared bRFS between the two modalities, and Cox regression identified factors associated with bRFS. The median follow-up time and patient age were 46.6 months and 71 years, respectively. The bRFS at 1, 2 and 5 years was 89.4, 87.2 and 79.9% for LDR, respectively, and 91.0, 82.8 and 72.2% for RP, respectively (P=0.077). The cRFS at 1, 2 and 5 years was 99.1, 97.7 and 94.9% for LDR, respectively, and 99.0, 96.2 and 94.5% for RP, respectively (P=0.630). It was indicated that LDR produced equivalent bRFS and cRFS rates compared with RP. The risk of biochemical failure (bF) was higher for the RP group compared with the LDR group in patients with a Gleason score ≤3+4 (P=0.022) or initial prostate specific antigen ≤10 ng/ml (P=0.002). Based on the univariate and multivariate logistic regression analysis of all 429 patients, T stage ≥T2b was an independent predictor for bF.