Selecting patients for exclusive permanent implant prostate brachytherapy: the experience of the Paris Institut Curie/Cochin Hospital/Necker Hospital group on 809 patients.
OBJECTIVE
The aim of this study was to analyze overall and relapse-free survival in a cohort of 809 patients, 34% of whom corresponded to a higher-risk group than American Brachytherapy Society (ABS) criteria.


METHODS
Between January 1999 and September 2004, 809 patients were treated with permanent loose 125 iodine seed implantation (IsoSeed Bebig, Eckert and Ziegler) by the Paris Institut Curie, Cochin Hospital, and Necker Hospital group. Of these 809 patients, 533 (65.9%) corresponded exactly to ABS criteria. Two hundred and seventy-six patients (34.1%) had a prostate-specific antigen (PSA) level between 10 and 15, or a Gleason score of 7, or both (non-ABS group).


RESULTS
Overall 5-year survival was 98%, with no difference between the ABS group and the non-ABS patient subgroups (p = 0.62).Five-year relapse-free survival was 97% in the ABS group; it was significantly lower (p = 0.001) in the non-ABS group but remained satisfactory at 94%. On subgroup analysis, the results appeared to be better for the subgroup of patients with PSA 10-15 than for the subgroup with a Gleason score of 7.


CONCLUSIONS
Our results suggest that selected patients in the intermediate-risk group of localized prostate cancers can be safely proposed as recipients of permanent implant brachytherapy as monotherapy.
Cosset
Jean-Marc
JM
Radiology Department, Institut Curie, Paris, France. jean-marc.cosset@curie.net
Flam
Thierry
T
Thiounn
Nicolas
N
Gomme
Stephanie
S
Rosenwald
Jean-Claude
JC
Asselain
Bernard
B
Pontvert
Dominique
D
Henni
Mehdi
M
Debre
Bernard
B
Chauveinc
Laurent
L
D001918:Brachytherapy / Q000401:mortality*; D015331:Cohort Studies; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000517:prevention & control*; D010297:Paris / Q000453:epidemiology; D018579:Patient Selection; D015995:Prevalence; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000532:radiotherapy*; D019736:Prostheses and Implants; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome