MP14-20 PROSTATE IMAGING REPORTING AND DATA SYSTEM SCORE BEFORE PROSTATE BIOPSY CAN PREDICT BIOCHEMICAL FAILURE IN PROSTATE CANCER PATIENTS TREATED WITH HIGH-DOSE-RATE BRACHYTHERAPY

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Radiation Therapy1 Apr 2016MP14-20 PROSTATE IMAGING REPORTING AND DATA SYSTEM SCORE BEFORE PROSTATE BIOPSY CAN PREDICT BIOCHEMICAL FAILURE IN PROSTATE CANCER PATIENTS TREATED WITH HIGH-DOSE-RATE BRACHYTHERAPY Keisuke Hata, Junpei Iizuka, Yasunobu Hashimoto, Tsunenori Kondo, Toshio Takagi, Hirohito Kobayashi, and Kazunari Tanabe Keisuke HataKeisuke Hata More articles by this author , Junpei IizukaJunpei Iizuka More articles by this author , Yasunobu HashimotoYasunobu Hashimoto More articles by this author , Tsunenori KondoTsunenori Kondo More articles by this author , Toshio TakagiToshio Takagi More articles by this author , Hirohito KobayashiHirohito Kobayashi More articles by this author , and Kazunari TanabeKazunari Tanabe More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2523AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Multiparametric magnetic resonance imaging (mp-MRI) and Prostate Imaging Reporting and Data System (PI-RADS) score have been reported to improve prostate cancer detection. However, whether PI-RADS score can predict the outcome of radiotherapy for non-metastatic prostate cancer remains unclear. This study evaluated the utility of mp-MRI and PI-RADS score for predicting biochemical failure in prostate cancer patients treated with high-dose-rate (HDR) brachytherapy. METHODS Between March 2007 and September 2011, 154 patients underwent HDR brachytherapy combined with external beam radiotherapy for non-metastatic prostate cancer. Of these patients, 84 who underwent mp-MRI before prostate biopsy were enrolled in this study. All the patients were classified as high-risk according to the D’Amico risk stratification. The doses used for HDR brachytherapy and external beam radiotherapy were 18 and 45 Gy, respectively. The patients also received neoadjuvant hormone therapy for 4 to 6 months and adjuvant hormone therapy for 6 months. The usefulness of mp-MRI was estimated by using the PI-RADS version 2. We analyzed retrospectively the prognostic factor of biochemical failure after HDR brachytherapy. RESULTS The median age of the patients was 66 years, and the median prostate-specific antigen (PSA) level was 15.8 ng/mL (range, 3.8–409 ng/mL). The clinical T stage was T1c-T2a in 25 patients (30%), T2b in 3 patients (3%), and T2c or higher in 56 patients (67%). Of the patients, 53 (63%) had a Gleason score of 8–10. Meanwhile, the PI-RADS score was 1–3 in 26 patients (31%), 4 in 27 patients (32%), and 5 in 31 patients (37%). The median duration of hormone therapy was 12.3 months. PSA failure after HDR brachytherapy occurred in 20 patients (23.8%). On multivariate Cox proportional hazards regression analysis, PSA failure after HDR brachytherapy was strongly associated with a PI-RADS score of 5 (p < 0.01). CONCLUSIONS Our study showed that a PI-RADS score of 5 was the independent predictive factor of PSA failure after HDR brachytherapy combined with hormone therapy. Performing mp-MRI with PI-RADS score before prostate biopsy can be helpful not only in prostate cancer detection but also in prediction of PSA failure after HDR brachytherapy. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e151 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Keisuke Hata More articles by this author Junpei Iizuka More articles by this author Yasunobu Hashimoto More articles by this author Tsunenori Kondo More articles by this author Toshio Takagi More articles by this author Hirohito Kobayashi More articles by this author Kazunari Tanabe More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...