Combined external beam radiotherapy and Pd-103 brachytherapy boost improves biochemical failure free survival in patients with clinically localized prostate cancer: results of a matched pair analysis.
BACKGROUND
Dose escalation has resulted in improved biochemical control in patients with clinically localized prostate cancer treated with conformal external beam radiation (EBRT). Conformal dose distributions may also be achieved with brachytherapy. Therefore, biochemical control was evaluated for patients treated with combined external radiation therapy and low dose rate brachytherapy (EBRT + LDR).


METHODS
A matched pair analysis was performed to compare biochemical control of patients treated with EBRT + LDR to patients treated with EBRT alone. The study endpoints were biochemical control and late toxicities.


RESULTS
The 5-year biochemical failure free survival (BFFS) was 86% for patients treated with EBRT + LDR and 72% for patients treated with EBRT (P = 0.03). Both treatments were associated with comparable incidences of late genitourinary (GU) side effects (18-19%). Late rectal toxicity was decreased by 15% in patients treated with EBRT + LDR (P = 0.0003).


CONCLUSIONS
These results support EBRT followed by brachytherapy boost as a safe and effective method for dose escalation in the treatment of prostate cancer.
Singh
Anu M
AM
Department of Radiation Medicine, Lombardi Cancer Center, Georgetown University Hospital, 3800 Reservation Rd. NW, LL Bles Bldg., Washington, DC, USA. dranusingh@yahoo.com
Gagnon
Gregory
G
Collins
Brian
B
Niroomand-Rad
Azam
A
McRae
Donald
D
Zhang
Ying
Y
Regan
James
J
Lynch
John
J
Dritschilo
Anatoly
A
D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D009367:Neoplasm Staging; D010165:Palladium / Q000627:therapeutic use*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000532:radiotherapy*; D011868:Radioisotopes / Q000627:therapeutic use*; D020266:Radiotherapy, Conformal / Q000379:methods*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D011868:Radioisotopes; D010165:Palladium; D017430:Prostate-Specific Antigen