Long-term outcome of early stage prostate cancer treated with brachytherapy analysis after a mean follow-up of 7 years.

Weigang Yan,Jian Chen,Zhien Zhou,Hanzhong Li,Yi Zhou,Zhipeng Mai,Zhigang Ji,Fuquan Zhang

doi:10.1186/2193-1801-3-357

Abstract

PurposeTo investigate the long-term efficacy of 125I brachytherapy in early-stage prostate cancer and to identify correlating factors.MethodsThis study included 117 cases of early stage prostate cancer. The patients ranged in age from 51 to 84 years, with a mean of 73 years. The features of the study population were as follows: the PSA ranged from 0.4 to 47.6 ng/ml (median, 14.7); the Gleason score ranged from 4 to 9 (mean, 6.4); the clinical stage ranged from T1b to T2c; and the positive biopsy rate ranged from 0.08 to 1.0 (mean, 0.45). The mean D90 was 142 Gy and ranged from 106 Gy to 170 Gy. The numbers of low-risk, intermediate-risk and high-risk prostate cancer cases were 22, 29 and 66, respectively. The biochemical no evidence of disease (bNED) rate and overall survival were recorded. Factors that correlated with the outcomes were evaluated.ResultsWith a mean follow up of 84 months, 33 cases had biochemical recurrence, with a bNED rate of 72%. The overall survival rate was 90%, and the cancer-specific survival rate was 97%. The bNED rates in the low-risk, intermediate-risk and high-risk groups were 86%, 79% and 64%, respectively (P = 0.040). The patients with PSA <20 ng/ml, a positive biopsy rate lower than 0.5, and D90 ≥ 140 Gy had lower biochemical recurrence (P = 0.028, 0.006, 0.009, respectively).ConclusionsThe long-term efficacy of 125I brachytherapy in early stage prostate cancer was shown. bNED is related to risk stratification, PSA level, positive biopsy rate and D90.

Highlights

Brachytherapy is a radical treatment that can achieve the same effect as radical prostatectomy and external beam radiotherapy (EBRT) (Nag et al 1999; Davis et al 2012; Park et al 2013)
Since the first introduction of 125I brachytherapy from western countries to China occurred more than a decade ago, few centers have reported long-term outcomes
This is one of the largest cohort of prostate cancer patients treated with brachytherapy with the longest follow-up from mainland China reported to date, though the results represent our early experience

Summary

Introduction

Brachytherapy is a radical treatment that can achieve the same effect as radical prostatectomy and external beam radiotherapy (EBRT) (Nag et al 1999; Davis et al 2012; Park et al 2013). Studies of the long-term clinical outcome in large cohorts of prostate cancer patients treated with brachytherapy from mainland China are lacking. A total of 564 patients with localized prostate cancer were treated with brachytherapy from December 2003 to August 2013 in Peking Union Medical College Hospital. Among the 138 patients who underwent brachytherapy before December 2007, 117 patients were followed

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Conclusion