title: Comparison of seed brachytherapy or external beam radiotherapy (70 Gy or 74 Gy) in 919 low-risk prostate cancer patients.
abstract: OBJECTIVE
  The aim of this analysis was to compare the biochemical no evidence of disease (bNED) rates in low-risk prostate cancer patients treated at two centers of excellence using different approaches: seed brachytherapy (BT) and external beam radiotherapy (EBRT).
  
  
  METHODS
  A total of 919 low-risk prostate cancer patients, treated from 1998-2008, were identified in the two databases. In Utrecht, 667 patients received I-125 BT applying a dose of 144 Gy. In Vienna, 252 patients were treated with EBRT, applying a local dose of 70 Gy in 82 patients and 74 Gy in 170 patients. bNED rates (Phoenix definition) were assessed.
  
  
  RESULTS
  The median follow-up was 46 months (range 1-148 months). The 5-year actuarial bNED rates were 94% for BT patients and 88% for EBRT patients (p = 0.002)-84% for patients receiving 70 Gy  and 91% for patients receiving 74 Gy, respectively. In the univariate analysis, patients receiving 70 Gy showed significantly worse outcome compared to BT (p = 0.001) and a difference close to significance compared to 74 Gy (p = 0.06). In the multivariate analysis including tumor stage, Gleason score, initial PSA, hormonal therapy, and dose, patients receiving 70 Gy EBRT showed significantly worse bNED rates compared to BT patients.
  
  
  CONCLUSIONS
  Low-risk prostate cancer patients receiving 74 Gy by EBRT show comparable biochemical control rates to patients receiving seed brachytherapy, whereas patients receiving 70 Gy show significantly worse outcome.
authors.affiliation: Department of Radiotherapy and Radiobiology, University Hospital of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. Gregor.Goldner@akhwien.at
authors.forename: G
authors.initials: G
authors.lastname: Goldner
authors.forename: R
authors.initials: R
authors.lastname: Pötter
authors.forename: J J
authors.initials: JJ
authors.lastname: Battermann
authors.forename: M P
authors.initials: MP
authors.lastname: Schmid
authors.forename: C
authors.initials: C
authors.lastname: Kirisits
authors.forename: S
authors.initials: S
authors.lastname: Sljivic
authors.forename: M
authors.initials: M
authors.lastname: van Vulpen
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001918:Brachytherapy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000379:methods*
chemical_list: D014408:Biomarkers, Tumor; D007457:Iodine Radioisotopes; D017430:Prostate-Specific Antigen