title: Permanent prostate brachytherapy and short-term androgen deprivation for intermediate-risk prostate cancer in Japanese men: outcome and toxicity.
abstract: OBJECTIVE
  To evaluate the interim outcomes of low-dose-rate permanent brachytherapy (PB) combined with short-term androgen deprivation therapy (ADT) in Japanese men with intermediate-risk prostate cancer excluding those with a Gleason score of 4+3.
  
  
  METHODS
  The Protocol-intermediate-risk group (Protocol-IRG) was defined as clinical stage T1c-T2c, Gleason score of 3+4, or lower and prostatic-specific antigen (PSA) level lower than 20 ng/mL. A total of 308 patients underwent brachytherapy in the protocol-IRG group (n=152) or in the low-risk group (n=156). Patients in Protocol-IRG had received at least 6 months of ADT before and after PB. Supplemental external beam radiotherapy was not used. Planned followup by PSA was carried out every 3 months for the first 2 years and every 6 months thereafter. The PSA failure was defined as nadir+2 ng/mL. Patients' Expanded Prostate Cancer Index Composite was recorded before and 3 years after treatment.
  
  
  RESULTS
  The median followup was 68 and 68 months for the protocol-IRG and the low-risk groups, respectively. The 5-year biological disease-free survival rates in the low-risk and protocol-IRG groups were 94.8 and 94.6%, respectively. As far as survival rates were concerned, there were no significant differences between the two groups. Overall satisfaction and sexual function at 3 years after PB had significantly improved compared with pretreatment (p=0.01 and p=0.01, respectively).
  
  
  CONCLUSIONS
  In intermediate-risk prostate patients, excluding those with a biopsy Gleason score of 4+3, brachytherapy with short-term ADT can be an effective treatment option for Japanese men.
authors.affiliation: Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Masui
authors.affiliation: Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Iwata
authors.affiliation: Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Naitoh
authors.affiliation: Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Yamada
authors.affiliation: Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Tsuneharu
authors.initials: T
authors.lastname: Miki
authors.affiliation: Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan. Electronic address: okiharakoji@hotmail.com.
authors.forename: Koji
authors.initials: K
authors.lastname: Okihara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D001706:Biopsy; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D007172:Erectile Dysfunction / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D017060:Patient Satisfaction; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D018931:Antineoplastic Agents, Hormonal; D007457:Iodine Radioisotopes; D017430:Prostate-Specific Antigen
keywords: Anti-androgen deprivation therapy; Brachytherapy; Intermediate risk; Prostate cancer