Long-Term Outcomes for Patients with Prostate Cancer Having Intermediate and High-Risk Disease, Treated with Combination External Beam Irradiation and Brachytherapy

Author:

Dattoli Michael1,Wallner Kent234,True Lawrence2,Bostwick David5,Cash Jennifer1,Sorace Richard1

Affiliation:

1. Dattoli Cancer Center & Brachytherapy Research Institute, 2803 Fruitville Rd., Sarasota, FL 34237-5367, USA

2. Department of Radiation Oncology and Pathology, University of Washington, Seattle, WA 98195-0001, USA

3. Radiation Oncology, Puget Sound Health Care System, Department of Veterans Affairs, Seattle, WA 98108-1597, USA

4. Group Health Cooperative, Seattle, WA 98124-1590, USA

5. Research Division, Bostwick Laboratories, Richmond, VA 23050-4410, USA

Abstract

Background. Perception remains that brachytherapy-based regimens are inappropriate for patients having increased risk of extracapsular extension (ECE).Methods. 321 consecutive intermediate and high-risk disease patients were treated between 1/92 and 2/97 by one author (M. Dattoli) and stratified by NCCN guidelines. 157 had intermediate-risk; 164 had high-risk disease. All were treated using the combination EBRT/brachytherapy hormones. Biochemical failure was defined using PSA and nadir +2 at last followup. Nonfailing patients followup was median 10.5 years. Both biochemical data and original biopsy slides were independently rereviewed at an outside institution.Results. Overall actuarial freedom from biochemical progression at 16 years was 82% (89% intermediate, 74% high-risk) with failure predictors: Gleason score and PSA . Hormonal therapy did not affect failure rates .Conclusion. This study helps to strengthen the rationale for brachytherapy-based regimens as being both durable and desirable treatment options for such patients. Prospective studies are justified to confirm these positive results.

Publisher

Hindawi Limited

Subject

Oncology

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