High-dose-rate brachytherapy combined with long-term hormonal therapy for high-risk prostate cancer: results of a retrospective analysis.
OBJECTIVE
High-dose-rate (HDR) brachytherapy combined with hormonal therapy (HTx), without the addition of external beam radiation therapy (EBRT) for high-risk prostate cancer was evaluated retrospectively.


METHODS
Between May 1995 and April 2002, 35 patients with prostate cancer [Stage > or = T2b (UICC 1997) or tumor grading=3 or prostate-specific antigen (PSA) level > or = 20 ng/mL] were treated with HDR brachytherapy combined with HTx. Most patients (74%) had two or more of these factors. All patients received Iridium-192 HDR brachytherapy with a total dose of 54 Gy/9 fractions/5 days (48 Gy/8 fractions/5 days for the first 6 cases) in one implant session. The median neoadjuvant HTx [luteinizing hormone-releasing hormone (LH-RH) agonist and antiandrogen] period was 7 months. The median adjuvant HTx (ATH) (LH-RH agonist) period was 40 months, and median follow-up was 57 months (range, 23-117 months).


RESULTS
The 5-year actuarial biochemical control, local control, and disease-free rates were 62%, 96%, and 76% respectively. No patients experienced local and/or regional relapse without distant progression. The 5-year actuarial cause-specific survival and overall survival rates were 89% and 87%, respectively. The acute and late toxicity were moderate and well tolerated.


CONCLUSIONS
HDR brachytherapy plus long-term HTx is at least as effective as conventional EBRT plus long-term HTx.
Oh
Ryoong-Jin
RJ
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Japan.
Yoshioka
Yasuo
Y
Tanaka
Eiichi
E
Shiomi
Hiroya
H
Sumida
Iori
I
Isohashi
Fumiaki
F
Suzuki
Osamu
O
Konishi
Koji
K
Kawaguchi
Yoshifumi
Y
Nakamura
Satoaki
S
Kato
Masahiro
M
Inoue
Takehiro
T
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D001918:Brachytherapy / Q000379:methods*; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D000726:Androgen Antagonists; D007496:Iridium Radioisotopes; D007987:Gonadotropin-Releasing Hormone