title: Permanent seed brachytherapy for clinically localized prostate cancer: long-term outcomes in a 700 patient cohort.
abstract: OBJECTIVE
  Few large European studies have evaluated long-term outcomes for permanent prostate brachytherapy (PPB) as monotherapy for clinically localized prostate cancer. The objective of the present study was to evaluate long-term survival in this patient profile.
  
  
  METHODS
  Retrospective study of 700 patients who underwent transperineal ultrasound-guided iodine-125 PPB (145 Gy) between January 2000 and July 2012. Median age was 64.8 years (range, 35-79). Most patients (638 of 700; 91%) had low-risk disease (D'Amico criteria). Eighty-five patients (12%) received hormonal treatment. Overall survival, cause-specific survival, and biochemical relapse-free survival were calculated and estimated using actuarial and Kaplan-Meier methods. Differences between groups were assessed using the log-rank test.
  
  
  RESULTS
  Median followup was 63 months (range, 6-164). At 5- and 10-year followup, respectively, overall survival was 94% (95% confidence interval [CI], 92-96) and 84% (95% CI, 78-90); cause-specific survival was 100% and 97% (95% CI, 95-99); and biochemical relapse-free survival was 95% (95% CI, 93-97) and 85% (95% CI, 79-91).
  
  
  CONCLUSIONS
  The long-term results presented in this report confirm previous studies and provide additional support for the use of PPB in patients with favorable-risk prostate cancer. Seed brachytherapy provides excellent long-term results in this patient profile.
authors.affiliation: Department of Radiation Oncology, Catalan Institute of Oncology, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Martinez
authors.affiliation: Department of Radiation Oncology, Policlinico di Palermo, Universitá degli Studi di Palermo, Palermo, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Daidone
authors.affiliation: Department of Radiation Oncology, Catalan Institute of Oncology, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Gutierrez
authors.affiliation: Department of Radiation Oncology, Catalan Institute of Oncology, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Pera
authors.affiliation: Department of Radiation Oncology, Catalan Institute of Oncology, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Boladeras
authors.affiliation: Department of Radiation Oncology, Catalan Institute of Oncology, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Ferrer
authors.affiliation: Department of Medical Physics, Catalan Institute of Oncology, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Franciso
authors.initials: F
authors.lastname: Pino
authors.affiliation: Department of Urology, Hospital de Bellvitge, Barcelona, Spain.
authors.forename: José Francisco
authors.initials: JF
authors.lastname: Suarez
authors.affiliation: Department of Radiation Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Polo
authors.affiliation: Department of Radiation Oncology, Catalan Institute of Oncology, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: guedea@iconcologia.net.
authors.forename: Ferran
authors.initials: F
authors.lastname: Guedea
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007457:Iodine Radioisotopes
keywords: Biochemical outcome; Brachytherapy; Clinically localized; Prostate cancer; Seed implant