2041 LOW-DOSE-RATE IODINE-125 SEEDS BRACHYTHERAPY: PSA NADIR LESS THAN 1 NG/ML AS PROGNOSTIC FACTOR

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You have accessJournal of UrologyProstate Cancer: Localized X1 Apr 20102041 LOW-DOSE-RATE IODINE-125 SEEDS BRACHYTHERAPY: PSA NADIR LESS THAN 1 NG/ML AS PROGNOSTIC FACTOR Leonardo O. Reis, C.R. Monti, Lisias N. Castilho, V.D. Gialluca, José A.S. Reinato, E. Uhmann, N.S. Kawakami, and Ubirajara Ferreira Leonardo O. ReisLeonardo O. Reis More articles by this author , C.R. MontiC.R. Monti More articles by this author , Lisias N. CastilhoLisias N. Castilho More articles by this author , V.D. GiallucaV.D. Gialluca More articles by this author , José A.S. ReinatoJosé A.S. Reinato More articles by this author , E. UhmannE. Uhmann More articles by this author , N.S. KawakamiN.S. Kawakami More articles by this author , and Ubirajara FerreiraUbirajara Ferreira More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2087AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Localized prostate cancer can be treated by surgery, external beam radiation or brachytherapy (low or high dose rate). Low dose brachytherapy was introduced in 1985 and it can be used as monotherapy or associated with external radiation therapy or in local recurrence after external radiotherapy. We evaluate the outcomes and morbidity of brachytherapy with permanent seed implantation of Iodine-125 in patients with localized prostate cancer classified as low and intermediate risk in a longitudinal retrospective uncontrolled study. METHODS Between February 2000 and February 2008, 560 patients were treated with brachytherapy of whom 366 with histologically confirmed, localized tumor, clinical stage T1b, T1c, T2a and T2b, Gleason ≤7 and PSA ≤20ng/ml were evaluated. Hormonal blockade for prostate volume reduction before the brachytherapy procedure was necessary in 32.8% of patients. The dependent variable studied was the time to death (prostate cancer and other causes). The independent variables were prognostic factors properly classified according to cutoffs of literature and/or median value. Kaplan-Meier method was used to calculate overall and specific survivals. A comparison of cumulative survival curves between the different categories of the same variable was assessed using the log-rank. SPSS (version 17.0) was utilized and the level of significance was 0.05. RESULTS The mean age was 67.8 years and mean follow-up 96 months. Prostate cancer specific survival was 94% (95% CI: 92%-96%) and overall survival was 78% (95% CI: 75%-81%). The survival rates were similar for patients < or > 70 years. Specific survival rate was higher for those with Gleason score < 7 compared to 7 (93 vs 76, p = 0.012). Patients with PSA < 10 had a higher specific survival rate compared to those with PSA ≥10 (93 vs. 63, p <0.005). Patients with PSA nadir <1 ng/ml had a longer survival when compared with those with PSA nadir ≥ 1 (92 vs 64, p = 0.005). The use of neoadjuvant hormonal blockade did not influence the outcomes. Toxicity was positively related to prostate volume; 50.3% of patients had grade 1 urinary toxicity, 40.2% grade 1 rectal toxicity and 31.4% grade 2 urinary or rectal toxicity. There was no grade 3 or 4 toxicity. CONCLUSIONS Prostate low-dose-rate Iodine-125 brachytherapy is an excellent choice for conservative treatment of localized prostate cancer in selected patients presenting small prostate, < 7 Gleason score and < 10 PSA (> 92 % long term survival). PSA nadir < 1 ng/mL is a good prognostic factor in these patients. Campinas, Brazil© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e792-e793 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Leonardo O. Reis More articles by this author C.R. Monti More articles by this author Lisias N. Castilho More articles by this author V.D. Gialluca More articles by this author José A.S. Reinato More articles by this author E. Uhmann More articles by this author N.S. Kawakami More articles by this author Ubirajara Ferreira More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...