High dose rate brachytherapy and external beam radiotherapy for local and locally advanced prostate cancer: Uni-institutional long term results.

Abstract

319 Background: Dose-escalation is a determining factor that influences biochemical control (BC) of prostate cancer. High-dose rate brachytherapy (HDR) is one method for providing BC. Methods: Patients with histological diagnosis Gleason scored (GS), clinical stage T1 to T3a, no evidence of metastatic disease, prostate volume > 20cc < 60cc and initial PSA (PSAi) < 60 mg/ml treated from 1997 to 2005 with an Institutional Policy of treatment were evaluated. Results: There were 273 patients treated with this treatment combination at AC Camargo Cancer Center, Sao Paulo, Brazil. The median age and FU time were 64.7 and 10.3 years, respectively. Two hundred thirteen (78.0%) patients had FU longer than 5 years. Actuarial 10-year OS, CSS and BC were 89.8%, 63.6% and 71.8%, respectively. On univariate analyses GS < 7, clinical stage < T2b, low risk group (LR), absence adjuvant androgen deprivation (ADT), age > 65, PSAi < 10, localized EBRT and three dimensional HDR planning were associated with improved CSS and BC. PSAi and age were not favorable associated to BC. Multivariate Cox regression analyses confirmed LR, GS < 7, PSAi < 10, absence of ADT, age < 65 years as predictors of improved CSS and BC. For OS only LR was confirmed as predictive factor. Conclusions: The present data represents a unique single institution study at long FU for the given technique and the comparison with the current literature data confirms the excellent results achieved with this treatment combination.