Four-year biochemical outcome after radioimmunoguided transperineal brachytherapy for patients with prostate adenocarcinoma.
OBJECTIVE
To evaluate 4-year biochemical outcomes for patients with prostate adenocarcinoma who underwent radioimmunoguided (Prostascint) permanent prostate brachytherapy.


METHODS
Eighty patients with clinical T1C-T3A NxM0 prostate cancer underwent ProstaScint-guided prostate brachytherapy using either (103)Pd or (125)I between February 1997 and December 2000. Sixty-seven patients underwent prostate brachytherapy alone, whereas 13 patients received neoadjuvant hormonal manipulation before implantation. Risk factors (RF) included PSA >10, Stage >or=T2b, and Gleason grade >or=7. Sixty patients had low-risk disease (0 RF), 17 were intermediate risk (1 RF), and 3 were high risk (2 RF). Biochemical disease-free survival (bDFS) was calculated using the American Society for Therapeutic Radiology and Oncology (ASTRO) consensus criteria, a PSA cutoff of 1.0 ng/mL, and a PSA cutoff of 0.5 ng/mL.


RESULTS
Four-year bDFS for the entire cohort was 97.4% using the ASTRO consensus criteria. Low-risk patients (60) had a 4-year bDFS of 100%; intermediate- and high-risk patients (20 patients) were 89.2%. The hormonally naïve group (67 patients) had a 4-year bDFS of 96.9% and a median PSA nadir of 0.2 ng/mL. Median time to nadir was 19.8 months (range: 1.9-53.2 months). For the neoadjuvant hormonal therapy group (13 patients), ASTRO-defined bDFS was 100%. Overall, 85.2% of patients had a posttreatment PSA <or=1.0 ng/mL, and 75.9% had a PSA <or=0.5 ng/mL at a median follow-up of 36 months.


CONCLUSIONS
At a median follow-up of 36 months, ProstaScint-guided transperineal brachytherapy results in a high probability of actuarial 4-year biochemical disease-free survival for patients with localized prostate cancer.
Ellis
Rodney J
RJ
Department of Radiation Oncology, Aultman Hospital, Canton, OH 44708, USA. rje2@po.cwru.edu
Vertocnik
Amy
A
Kim
Edward
E
Zhou
Hang
H
Young
Benjamin
B
Sodee
Bruce
B
Fu
Pingfu
P
Beddar
Sam
S
Colussi
Valdir
V
Spirnak
John P
JP
Dinchman
Kurt H
KH
Resnick
Martin
M
Kinsella
Timothy J
TJ
D000230:Adenocarcinoma / Q000097:blood* / Q000401:mortality / Q000532:radiotherapy*; D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010165:Palladium / Q000627:therapeutic use; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000401:mortality / Q000532:radiotherapy*; D016719:Radioimmunodetection; D011868:Radioisotopes / Q000627:therapeutic use; D011879:Radiotherapy Dosage; D013997:Time Factors
D007457:Iodine Radioisotopes; D011868:Radioisotopes; D010165:Palladium; D017430:Prostate-Specific Antigen