title: Results of a cohort of 200 hormone-naïve consecutive patients with prostate cancer treated with iodine 125 permanent interstitial brachytherapy by the same multidisciplinary team.
abstract: OBJECTIVE
  To report survival and morbidity of a cohort of 200 hormone-naïve consecutive patients with localized prostate cancer, treated by low-dose rate brachytherapy within the frame of multidisciplinary approach.
  
  
  METHODS
  Between 2001 and 2011, 200 patients were treated by the same team with 125 iodine seeds: 167 low-risk and 33 intermediate risk according to the d'Amico classification; eligible patients had clinical stage T1/T2a-b, Gleason score 3+3 or 3+4, baseline prostate-specific antigen level below 15ng/mL, prostate volume less than 60cm(3). The median number of random biopsies was 12 (range 6-32) and the breakdown of positive cores was as follows: 1 (29%), 2 (35%), 3 or more (36%). Acute morbidity was assessed according to the Common Terminology Criteria for Adverse Events and late toxicity according to the EORTC/RTOG scale. Data were prospectively collected.
  
  
  RESULTS
  The median follow-up was 69 months (range 16 to 135). The 5- and 10-year biochemical relapse free survivals were 95.6% (95% confidence interval [CI]: 91-98) and 89.7% (95% CI: 79.4-95.0). The 5-year and 10-year overall survival were respectively 96.4% (95% CI: 92-98.4) and 89.7% (95% CI: 80.8-94.6%) and the 10-year disease specific survival, 99.1% (95% CI: 93.0-99.9). The 5- and 10-year grade 3 acute toxicity cumulative rate were respectively 3.3% (95% CI: 1.4-6.6) and 4% (95% CI: 1.4-6.6) and the 5- and 10-year grades 3 cumulative late toxicity 2.5% (95% CI: 2.0-5.9) and 4% (95% CI: 2.0-5.9).
  
  
  CONCLUSIONS
  Brachytherapy managed within the frame of a multidisciplinary approach - from diagnosis to evaluation - may offer optimized results with a reduced late toxicity rate, while remaining opened to dosimetry and technical improvements.
authors.affiliation: Département d'oncologie-radiothérapie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Bolla
authors.affiliation: Département d'oncologie-radiothérapie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France. Electronic address: cverry@chu-grenoble.fr.
authors.forename: C
authors.initials: C
authors.lastname: Verry
authors.affiliation: Département d'oncologie-radiothérapie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France.
authors.forename: J-Y
authors.initials: JY
authors.lastname: Giraud
authors.affiliation: Département d'urologie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France.
authors.forename: J-A
authors.initials: JA
authors.lastname: Long
authors.affiliation: Département d'oncologie-radiothérapie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Conil
authors.affiliation: Département d'oncologie-radiothérapie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France.
authors.forename: R
authors.initials: R
authors.lastname: Abidi
authors.affiliation: Équipe GMCAO, Laboratoire TIMC-IMAG, université Joseph-Fourier, Domaine de la Merci, 38706 La Tronche cedex, France; CNRS UMR 5525, domaine de la Merci, 38706 La Tronche cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Troccaz
authors.affiliation: Registre des cancers de l'Isère, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Colonna
authors.affiliation: Département d'urologie, CHU de Grenoble, BP 217, 38043 Grenoble cedex 9, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Descotes
mesh_terms: D001918:Brachytherapy; D015331:Cohort Studies; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local; D010348:Patient Care Team; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D014570:Urologic Diseases / Q000209:etiology
chemical_list: D007457:Iodine Radioisotopes; D017430:Prostate-Specific Antigen
keywords: Brachytherapy; Cancer de la prostate localisé; Curiethérapie; Iode 125; Iodine 125; Localized prostate cancer