Prostate Brachytherapy in Men {>=}75 Years of Age

Journal Article · Wed Oct 01 04:00:00 EDT 2008 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.01.017· OSTI ID:21124467

Wallner, Kent E ^[1]; Galbreath, Robert W ^[2]; Butler, Wayne M; Brammer, Sarah G; Allen, Zachariah A ^[2]; Adamovich, Edward ^[3]

---

1. Puget Sound Healthcare Corporation, Group Health Cooperative, University of Washington, Seattle, WA (United States)
2. Schiffler Cancer Center and Wheeling Jesuit University, Wheeling, WV (United States)
3. Department of Pathology, Wheeling Hospital, Wheeling, WV (United States)

Purpose: To evaluate cause-specific survival (CSS), biochemical progression-free survival (bPFS), and overall survival (OS) in prostate cancer patients aged {>=}75 years undergoing brachytherapy with or without supplemental therapies. Methods and Materials: Between April 1995 and August 2004, 145 consecutive patients aged {>=}75 years underwent permanent prostate brachytherapy. Median follow-up was 5.8 years. Biochemical progression-free survival was defined by a prostate-specific antigen level {<=}0.40 ng/mL after nadir. Patients with metastatic prostate cancer or hormone-refractory disease without obvious metastases who died of any cause were classified as dead of prostate cancer. All other deaths were attributed to the immediate cause of death. Multiple clinical, treatment, and dosimetric parameters were evaluated for impact on survival. Results: Nine-year CSS, bPFS, and OS rates for the entire cohort were 99.3%, 97.1%, and 64.5%, respectively. None of the evaluated parameters predicted for CSS, whereas bPFS was most closely predicted by percentage positive biopsies. Overall survival and non-cancer deaths were best predicted by tobacco status. Thirty-seven patients have died, with 83.8% of the deaths due to cardiovascular disease (22 patients) or second malignancies (9 patients). To date, only 1 patient (0.7%) has died of metastatic prostate cancer. Conclusions: After brachytherapy, high rates of CSS and bPFS are noted in elderly prostate cancer patients. Overall, approximately 65% of patients are alive at 9 years, with survival most closely related to tobacco status. We believe our results support an aggressive locoregional approach in appropriately selected elderly patients.

• OSTI ID: 21124467
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 72; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ANTIGENS
BIOPSY
BRACHYTHERAPY
CARDIOVASCULAR DISEASES
DEATH
ELDERLY PEOPLE
HORMONES
METASTASES
PATIENTS
PROSTATE