title: Analysis of monotherapy prostate brachytherapy in patients with prostate cancer. Initial PSA and Gleason are important for recurrence?
abstract: OBJECTIVE
  To evaluate the clinical outcome of a cohort of localized prostate cancer patients treated with 125-I permanent brachytherapy at the São José Hospital--CHLC, Lisbon.
  
  
  METHODS
  A retrospective analysis was carried out on 429 patients with low and intermediate-risk of prostate adenocarcinoma, according to the recommendations of the EORTC, who underwent 125I brachytherapies in intraoperative dosimetry "real-time" system between September 2003 and September 2013.
  
  
  RESULTS
  The mean follow-up was 71.98 months. Biochemical relapse of disease by rising PSA (Phoenix criterion) was observed in 18 patients (4.2%). Through the application of Kaplan-Meier survival curves in this sample, the rate of survival at 6 years without biochemical relapse was higher than 95%. By Iog rank test comparing biochemical relapse with initial PSA (15-10 and <10) and Gleason values (7 and <7), there was no statistical difference (P=0.830) of the initial PSA in the probability of developing biochemical relapse. In relation to Gleason score, it was noted a statistical difference (P <0.05), demonstrating that patients with Gleason 7 are more likely to develop biochemical relapse.
  
  
  CONCLUSIONS
  Brachytherapy as monotherapy is at present an effective choice in the treatment of localized prostate adenocarcinoma. Biochemical relapses are minimal. The initial PSA showed no statistically difference in the rate of relapses, unlike the value Gleason, where it was demonstrated that patients with Gleason 7 have a higher probability of biochemical relapse. Cases with PSA bounce should be controlled before starting a salvage treatment.
authors.affiliation: Section of Urology, São José Hospital, CHLC, Lisboa, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Galego
authors.affiliation: Section of Urology, São José Hospital, CHLC, Lisboa, Portugal.
authors.forename: Fernando C
authors.initials: FC
authors.lastname: Silva
authors.affiliation: Section of Urology, São José Hospital, CHLC, Lisboa, Portugal.
authors.forename: Luís Campos
authors.initials: LC
authors.lastname: Pinheiro
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000532:radiotherapy*; D000367:Age Factors; D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000532:radiotherapy*; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors
chemical_list: D007457:Iodine Radioisotopes; D017430:Prostate-Specific Antigen