title: Comparison between preoperative and real-time intraoperative planning ¹²⁵I permanent prostate brachytherapy: long-term clinical biochemical outcome.
abstract: BACKGROUND
  The purpose of the study is to evaluate the long-term clinical outcome through biochemical no evidence of disease (bNED) rates among men with low to intermediate risk prostate cancer treated with two different brachytherapy implant techniques: preoperative planning (PP) and real-time planning (IoP).
  
  
  METHODS
  From June 1998 to July 2011, 1176 men with median age of 67 years and median follow-up of 47 months underwent transperineal ultrasound-guided prostate ¹²⁵I-brachytherapy using either PP (132) or IoP (1044) for clinical T1c-T2b prostate adenocarcinoma Gleason <8 and prostate-specific antigen (PSA) <20 ng/ml. Men with Gleason 7 received combination of brachytherapy, external beam radiation and 6-month androgen deprivation therapy (ADT). Biological effective dose (BED) was calculated using computerized tomography (CT)-based dosimetry 1-month postimplant. Failure was determined according to the Phoenix definition.
  
  
  RESULTS
  The 5- and 7-year actuarial bNED rate was 95% and 90% respectively. The 7-year actuarial bNED was 67% for the PP group and 95% for the IoP group (P < 0.001). Multivariate Cox regression analyses identified implant technique or BED, ADT and PSA as independent prognostic factors for biochemical failure.
  
  
  CONCLUSIONS
  Following our previous published results addressing the limited and disappointing outcomes of PP method when compared to IoP based on CT dosimetry and PSA kinetics, we now confirm the long-term clinical, bNED rates clear cut superiority of IoP implant methodology.
authors.forename: Haim
authors.initials: H
authors.lastname: Matzkin
authors.forename: Juza
authors.initials: J
authors.lastname: Chen
authors.forename: Larissa
authors.initials: L
authors.lastname: German
authors.affiliation: Department of Urology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. nicolam@tlvmc.gov.il.
authors.forename: Nicola J
authors.initials: NJ
authors.lastname: Mabjeesh
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000532:radiotherapy*; D011874:Radiometry / Q000379:methods; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D012306:Risk; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes; D017430:Prostate-Specific Antigen