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

Abstract

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 aremore » 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.« less

Authors:
 [1];  [2]; ; ;  [2];  [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)
Publication Date:
OSTI Identifier:
21124467
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 72; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2008.01.017; PII: S0360-3016(08)00135-1; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANTIGENS; BIOPSY; BRACHYTHERAPY; CARDIOVASCULAR DISEASES; DEATH; ELDERLY PEOPLE; HORMONES; METASTASES; PATIENTS; PROSTATE

Citation Formats

Merrick, Gregory S., Wallner, Kent E, Galbreath, Robert W, Ohio University Eastern, St. Clairsville, OH, Butler, Wayne M, Brammer, Sarah G, Allen, Zachariah A, and Adamovich, Edward. Prostate Brachytherapy in Men {>=}75 Years of Age. United States: N. p., 2008. Web. doi:10.1016/j.ijrobp.2008.01.017.
Merrick, Gregory S., Wallner, Kent E, Galbreath, Robert W, Ohio University Eastern, St. Clairsville, OH, Butler, Wayne M, Brammer, Sarah G, Allen, Zachariah A, & Adamovich, Edward. Prostate Brachytherapy in Men {>=}75 Years of Age. United States. https://doi.org/10.1016/j.ijrobp.2008.01.017
Merrick, Gregory S., Wallner, Kent E, Galbreath, Robert W, Ohio University Eastern, St. Clairsville, OH, Butler, Wayne M, Brammer, Sarah G, Allen, Zachariah A, and Adamovich, Edward. 2008. "Prostate Brachytherapy in Men {>=}75 Years of Age". United States. https://doi.org/10.1016/j.ijrobp.2008.01.017.
@article{osti_21124467,
title = {Prostate Brachytherapy in Men {>=}75 Years of Age},
author = {Merrick, Gregory S. and Wallner, Kent E and Galbreath, Robert W and Ohio University Eastern, St. Clairsville, OH and Butler, Wayne M and Brammer, Sarah G and Allen, Zachariah A and Adamovich, Edward},
abstractNote = {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.},
doi = {10.1016/j.ijrobp.2008.01.017},
url = {https://www.osti.gov/biblio/21124467}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 2,
volume = 72,
place = {United States},
year = {Wed Oct 01 00:00:00 EDT 2008},
month = {Wed Oct 01 00:00:00 EDT 2008}
}