Five-year biochemical outcome after prostate brachytherapy for hormone-naive men < or = 62 years of age.
OBJECTIVE
To evaluate 5-year biochemical disease-free outcome for hormone naïve men 62 years of age or less who underwent transperineal ultrasound-guided permanent prostate brachytherapy.


METHODS
76 patients underwent transperineal ultrasound guided prostate brachytherapy using either (103)Pd or (125)I for clinical T1b--T2b NxM0 (1997 AJCC) adenocarcinoma of the prostate gland from April 1995 to October 1999. No patient was lost to follow-up, and no patient underwent pathologic lymph-node staging. 47 patients were implanted with either (103)Pd or (125)I monotherapy, and 29 patients received moderate-dose external-beam radiation therapy followed by a prostate brachytherapy boost. No patient received hormonal manipulation. The median patient age was 58 years (range, 48--62 years). The median follow-up was 37 months (range, 14--70 months). Follow-up was calculated from the day of implantation. Biochemical disease-free survival was defined by the American Society of Therapeutic Radiation and Oncology (ASTRO) consensus definition.


RESULTS
The actuarial 5-year biochemical disease-free survival rate was 98.7%. For patients with low-, intermediate-, and high-risk disease, 97.7%, 100%, and 100%, respectively, were free of biochemical failure. The median posttreatment prostate-specific antigen (PSA) for the entire group was 0.2 ng/mL. When stratified by risk group, the median posttreatment PSA was 0.2, 0.15, and 0.1 for patients with low-, intermediate-, and high-risk disease, respectively.


CONCLUSIONS
With a median follow-up of 37 months, hormone naïve patients < or = 62 years of age have a high probability of 5-year biochemical disease-free survival following permanent prostate brachytherapy with an apparent plateau on the PSA curve.
Merrick
G S
GS
Schiffler Cancer Center, Wheeling Hospital, Wheeling, WV 26003-6300, USA. schifonc@wheelinghosp.com
Butler
W M
WM
Lief
J H
JH
Galbreath
R W
RW
D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy*; D000328:Adult; D001918:Brachytherapy; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D010165:Palladium / Q000627:therapeutic use; D011471:Prostatic Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D011868:Radioisotopes / Q000627:therapeutic use; D012074:Remission Induction; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D007457:Iodine Radioisotopes; D011868:Radioisotopes; D010165:Palladium