Two-year PSA outcomes after cesium prostate brachytherapy.

Abstract

92 Background: Given the long natural history of prostate cancer, long term follow up is needed to definitively know the efficacy of a new treatment, in this case 131Cs brachytherapy. However, it is also important to report on short term outcomes to ensure that this treatment is on course to provide equivalent outcomes as compared to existing treatment options. This reports two year PSA outcomes in men undergoing prostate brachytherapy with cesium 131 at a single institution. Methods: All patients who underwent prostate brachytherapy with 131Cs and had at least 24 months of follow up were included in this study. Results are reported for the total cohort and stratified by risk group as well as treatment received (monotherapy, combination therapy, or trimodal therapy). The Phoenix definition was used to define biochemical disease free survival (bDFS). Outcomes were analyzed using descriptive statistics. Results: 115 patients underwent prostate brachytherapy with 131Cs and had at least 24 months of follow up. Fifty two (45.2%) patients were classified as low risk, 52 (45.2%) were intermediate risk, and 11 (9.6%) were high risk. Eighty one patients were treated with prostate brachytherapy as monotherapy, including six patients who received androgen-deprivation therapy (ADT) in combination with their brachytherapy. Twenty five patients received combination therapy, and 9 patients received trimodal therapy. Specifics of bDFS rates and PSA data are reported in the table. Of the 115 patients four had biochemical recurrence. Two patients died during the study period, both due to causes other than prostate cancer, and one patient was unwilling to obtain a PSA at the 24 month follow up time point. Conclusions: The first 115 patients who have undergone prostate brachytherapy with 131Cs at our institution have a bDFS rate of 96.4% 24 months after their procedure. With the very important caveat that only short term results are reported, 131Cs appears to be on course to achieve results comparable to those achieved with iodine 125 (125I) and palladium 103 (103Pd). [Table: see text] No significant financial relationships to disclose.