title: Prostate brachytherapy in men > or =75 years of age.
abstract: OBJECTIVE
  To evaluate cause-specific survival (CSS), biochemical progression-free survival (bPFS), and overall survival (OS) in prostate cancer patients aged > or =75 years undergoing brachytherapy with or without supplemental therapies.
  
  
  METHODS
  Between April 1995 and August 2004, 145 consecutive patients aged > or =75 years underwent permanent prostate brachytherapy. Median follow-up was 5.8 years. Biochemical progression-free survival was defined by a prostate-specific antigen level < or =0.40 ng/mL after nadir. Patients with metastatic prostate cancer or hormone-refractory disease without obvious metastases who died of any cause were classified as dead of prostate cancer. All other deaths were attributed to the immediate cause of death. Multiple clinical, treatment, and dosimetric parameters were evaluated for impact on survival.
  
  
  RESULTS
  Nine-year CSS, bPFS, and OS rates for the entire cohort were 99.3%, 97.1%, and 64.5%, respectively. None of the evaluated parameters predicted for CSS, whereas bPFS was most closely predicted by percentage positive biopsies. Overall survival and non-cancer deaths were best predicted by tobacco status. Thirty-seven patients have died, with 83.8% of the deaths due to cardiovascular disease (22 patients) or second malignancies (9 patients). To date, only 1 patient (0.7%) has died of metastatic prostate cancer.
  
  
  CONCLUSIONS
  After brachytherapy, high rates of CSS and bPFS are noted in elderly prostate cancer patients. Overall, approximately 65% of patients are alive at 9 years, with survival most closely related to tobacco status. We believe our results support an aggressive locoregional approach in appropriately selected elderly patients.
authors: Schiffler Cancer Center and Wheeling Jesuit University, Wheeling, WV 26003-6300, USA. gmerrick@urologicresearchinstitute.org
authors: Gregory S
authors: GS
authors: Merrick
authors: Kent E
authors: KE
authors: Wallner
authors: Robert W
authors: RW
authors: Galbreath
authors: Wayne M
authors: WM
authors: Butler
authors: Sarah G
authors: SG
authors: Brammer
authors: Zachariah A
authors: ZA
authors: Allen
authors: Edward
authors: E
authors: Adamovich
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001918:Brachytherapy / Q000379:methods*; D002423:Cause of Death; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality / Q000532:radiotherapy*; D012189:Retrospective Studies
chemical_list: D017430:Prostate-Specific Antigen