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Biochemical disease-free survival following I-125 prostate implantation

Abstract

Purpose/Objective: To assess the five-year clinical and biochemical results of ultrasound-guided permanent I-125 brachytherapy in early prostate cancer. Biochemical disease-free survival (BDFS) is reported, using PSA follow-up and is compared to the surgical and radiation therapy literature. Materials and Methods: From 12/88 through 12/93, ultrasound-guided brachytherapy was preplanned with I-125 and delivered 16,000 cGy as the sole treatment in 499 patients. All were clinically staged as T1 or T2 - N0M0 adenocarcinoma of the prostate. Within the first year, 19 patients were lost to follow-up and have been excluded from further study. The remaining 480 patients form the basis of this report. Clinical status and PSA values were systematically recorded before and after treatment. Results: With a median follow-up of 35 months (3-70) the actuarial clinical local control is 83%. Both stage and grade are shown to predict for this endpoint. Actuarial BDFS is also correlated with stage, grade, and PSA at presentation. Biochemical disease-free survival at five years is 94% for T1, 70% for unilateral T2, and 34% for T2c tumors. Grade is also predictive, ranging from 85% in low-grade tumors to 30% in high-grade tumors. In a multivariate analysis, the pretreatment PSA is most highly correlated (p <  More>>
Publication Date:
Jul 01, 1995
Product Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 32; Journal Issue: 971; Other Information: Copyright (c) 1995 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); PBD: 1995
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; IODINE 125; MULTIVARIATE ANALYSIS; PROSTATE; RADIATION SOURCE IMPLANTS; RADIOTHERAPY; SIDE EFFECTS; SURGERY; SURVIVAL CURVES; ULTRASONOGRAPHY
OSTI ID:
20420738
Country of Origin:
United States
Language:
English
Other Identifying Numbers:
Journal ID: ISSN 0360-3016; IOBPD3; TRN: US03R1979005143
Submitting Site:
INIS
Size:
page(s) 254
Announcement Date:

Citation Formats

Beyer, David C, and Priestley, Joseph B. Biochemical disease-free survival following I-125 prostate implantation. United States: N. p., 1995. Web. doi:10.1016/0360-3016(95)97887-7.
Beyer, David C, & Priestley, Joseph B. Biochemical disease-free survival following I-125 prostate implantation. United States. doi:10.1016/0360-3016(95)97887-7.
Beyer, David C, and Priestley, Joseph B. 1995. "Biochemical disease-free survival following I-125 prostate implantation." United States. doi:10.1016/0360-3016(95)97887-7. https://www.osti.gov/servlets/purl/10.1016/0360-3016(95)97887-7.
@misc{etde_20420738,
title = {Biochemical disease-free survival following I-125 prostate implantation}
author = {Beyer, David C, and Priestley, Joseph B}
abstractNote = {Purpose/Objective: To assess the five-year clinical and biochemical results of ultrasound-guided permanent I-125 brachytherapy in early prostate cancer. Biochemical disease-free survival (BDFS) is reported, using PSA follow-up and is compared to the surgical and radiation therapy literature. Materials and Methods: From 12/88 through 12/93, ultrasound-guided brachytherapy was preplanned with I-125 and delivered 16,000 cGy as the sole treatment in 499 patients. All were clinically staged as T1 or T2 - N0M0 adenocarcinoma of the prostate. Within the first year, 19 patients were lost to follow-up and have been excluded from further study. The remaining 480 patients form the basis of this report. Clinical status and PSA values were systematically recorded before and after treatment. Results: With a median follow-up of 35 months (3-70) the actuarial clinical local control is 83%. Both stage and grade are shown to predict for this endpoint. Actuarial BDFS is also correlated with stage, grade, and PSA at presentation. Biochemical disease-free survival at five years is 94% for T1, 70% for unilateral T2, and 34% for T2c tumors. Grade is also predictive, ranging from 85% in low-grade tumors to 30% in high-grade tumors. In a multivariate analysis, the pretreatment PSA is most highly correlated (p < 0.0001). Patients with a normal pretreatment PSA enjoyed 93% BDFS, while those presenting with PSA > 10 had a BDFS of 40%. Complications have been few, with severe urinary urgency or dysuria in 4% and both incontinence and proctitis seen in 1%. Conclusion: While biochemical disease-free survival reports in the literature are immature and have short follow-up, our data compares favorably with studies following radical prostatectomy or radiation therapy. Further follow-up of this cohort is required. The complication rate is low and patient acceptance excellent. Permanent implantation of I-125 as the sole treatment for early prostate cancer is a viable alternative for patients with early stage and low- to moderate-grade cancers. The PSA provides significant prognostic information and aids in case selection. Better management options are needed for high-grade and bilateral tumors.}
doi = {10.1016/0360-3016(95)97887-7}
journal = {International Journal of Radiation Oncology, Biology and Physics}
issue = {971}
volume = {32}
journal type = {AC}
place = {United States}
year = {1995}
month = {Jul}
}