title: 125I brachytherapy for localized prostate cancer: a single institution experience.
abstract: OBJECTIVE
  To evaluate the clinical outcome of a cohort of localized prostate cancer patients treated with 125I permanent brachytherapy at the University of Turin.
  
  
  METHODS
  A retrospective analysis was carried out on 167 consecutive patients with early stage prostate adenocarcinoma who underwent 125I brachytherapy between January 2003 and December 2010. A minimum follow-up of ≥ 12 months was mandatory for inclusion. Biochemical disease-free survival (defined on the basis of the ASTRO definition and the ASTRO-Phoenix definition) was chosen as the primary end point. Secondary end points were gastrointestinal and genitourinary toxicity (acute and late, defined according to the RTOG scale).
  
  
  RESULTS
  With a median follow-up of 42 months (range, 13.5-90.7), biochemical disease-free survival at 3 and 5 years was respectively 91.1% and 85.7%, according to the ASTRO definition and 94.5% and 85.1% according to ASTRO-Phoenix definition (for statistical purposes, only the ASTRO definition was used). Hormone treatment and nadir PSA (cutoff of 0.35 ng/ml) were the only factors affecting biochemical disease-free survival both on univariate (P = 0.02 and P = 0.001, respectively) and multivariate analysis (HR 0.024; P = 0.021 and HR 21.6; P = 0.006, respectively). Only 3.6% of patients experienced ≥ grade 3 acute urinary toxicity and 5% ≥ grade 3 late urinary toxicity. Prior transurethral prostate resection was the only independent predictor of grade 3 late urinary toxicity on multivariate analysis (HR 0.13; P = 0.009).
  
  
  CONCLUSIONS
  This mono-institutional series confirmed that brachytherapy is an effective and safe treatment modality for localized prostate cancer, with acceptable short- and long-term morbidity rates.
authors.affiliation: Radiation Oncology, Department of Medical and Surgical Sciences, University of Turin, S Giovanni Battista, Turin, Italy. alessia.guarneri@virgilio.it
authors.forename: Alessia
authors.initials: A
authors.lastname: Guarneri
authors.forename: Angela
authors.initials: A
authors.lastname: Botticella
authors.forename: Andrea Riccardo
authors.initials: AR
authors.lastname: Filippi
authors.forename: Fernando
authors.initials: F
authors.lastname: Munoz
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Beltramo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Casetta
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Giglioli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tizzani
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ragona
authors.forename: Umberto
authors.initials: U
authors.lastname: Ricardi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D018572:Disease-Free Survival; D053159:Dysuria / Q000209:etiology; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D020360:Neoadjuvant Therapy / Q000379:methods; D060787:Neoplasm Grading; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000276:immunology / Q000473:pathology / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016055:Urinary Retention / Q000209:etiology; D014551:Urinary Tract / Q000528:radiation effects*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D007457:Iodine Radioisotopes; D017430:Prostate-Specific Antigen