title: Interstitial implant alone or in combination with external beam radiation therapy for intermediate-risk prostate cancer: a survey of practice patterns in the United States.
abstract: OBJECTIVE
  This study is aimed at understanding and defining the current patterns of care with respect to prostate brachytherapy for patients with intermediate-risk localized disease in the combined academic and community setting.
  
  
  METHODS
  A nomogram-based survey was developed at the Seattle Prostate Institute defining the accepted criteria for intermediate-risk prostate cancer. Patients were defined as having intermediate-risk prostate cancer if they met one of the following criteria: prostate-specific antigen (PSA) >10 ng/dL, Gleason score (GS) > or = 7, or cT2b or cT2c disease. Additional potential predictive factors including perineural invasion (PNI), GS 3+4 vs. 4+3, and high-volume disease were included.
  
  
  RESULTS
  In the absence of PNI, all of those surveyed would perform monotherapy for intermediate-risk patients, GS 7 (3+4) or PSA 10-20, with cT1c and <30% cores +. Up to 80% would perform monotherapy for patients with cT1c, GS 7 (4+3), and <30% cores +. Eighty to 90% of physicians would perform an implant alone with cT2a and either a PSA of 10-20 or GS of 7 (3+4) and <30% cores +. Fifty to 60% of those surveyed stated that they would treat a patient with cT2b disease, GS 7 (3+4), or PSA 11-20, with less than two-thirds of the biopsy cores positive in the absence of PNI.
  
  
  CONCLUSIONS
  This Patterns of Care (POC) study reveals that certain subsets of intermediate-risk localized prostate cancer patients are considered appropriate candidates for an interstitial implant alone.
authors.affiliation: Department of Radiation Oncology, The University of Texas, M. D. Anderson Cancer Center, Houston, TX 77030, USA. sjfrank@mdanderson.org
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Frank
authors.forename: Peter D
authors.initials: PD
authors.lastname: Grimm
authors.forename: John E
authors.initials: JE
authors.lastname: Sylvester
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Merrick
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Davis
authors.forename: Anthony
authors.initials: A
authors.lastname: Zietman
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Moran
authors.forename: David C
authors.initials: DC
authors.lastname: Beyer
authors.forename: Mack
authors.initials: M
authors.lastname: Roach
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Clarke
authors.forename: Richard G
authors.initials: RG
authors.lastname: Stock
authors.forename: W
authors.initials: W
authors.lastname: Robert Lee
authors.forename: Jeff M
authors.initials: JM
authors.lastname: Michalski
authors.forename: Kent E
authors.initials: KE
authors.lastname: Wallner
authors.forename: Mark
authors.initials: M
authors.lastname: Hurwitz
authors.forename: Louis
authors.initials: L
authors.lastname: Potters
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Kuban
authors.forename: Bradley R
authors.initials: BR
authors.lastname: Prestidge
authors.forename: Robyn
authors.initials: R
authors.lastname: Vera
authors.forename: Shannon
authors.initials: S
authors.lastname: Hathaway
authors.forename: John C
authors.initials: JC
authors.lastname: Blasko
mesh_terms: D001707:Biopsy, Needle; D001918:Brachytherapy; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D009361:Neoplasm Invasiveness; D018579:Patient Selection; D010818:Practice Patterns, Physicians'; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D012189:Retrospective Studies; D012306:Risk; D014481:United States
chemical_list: D007457:Iodine Radioisotopes