title: Long term outcome and side effects in patients receiving low-dose I125 brachytherapy: a retrospective analysis.
abstract: OBJECTIVE
  To retrospectively evaluate the disease free survival (DFS),disease specific survival (DSS),overall survival (OS) and side effects in patients who received low-dose rate (LDR) brachytherapy with I125 stranded seeds.
  
  
  METHODS
  Between july 2003 and august 2012, 274 patients with organ confined prostate cancer were treated with permanent I125 brachytherapy. The median follow-up, age and pretreatment prostate specific antigen (iPSA) was 84 months (12-120), 67 years (50-83) and 7.8 ng/mL (1.14-38), respectively. Median Gleason score was 6 (3-9). 219 patients (80%) had stage cT1c, 42 patients (15.3%) had stage cT2a, 3 (1.1%) had stage cT2b and 3 (1.1%) had stage cT2c. The median D90 was 154.3 Gy (102.7-190.2).
  
  
  RESULTS
  DSS was 98.5%.OS was 93.5%. 13 patients (4.7%) developed systemic disease, 7 patients (2.55%) had local progression. In 139 low risk patients, the 5 year biochemical freedom from failure rate (BFFF) was 85% and 9 patients (6.4%) developed clinical progression. In the intermediate risk group, the 5 year BFFF rate was 70% and 5 patients (7.1%) developed clinical progression. Median nPSA in patients with biochemical relapse was 1.58 ng/mL (0.21 - 10.46), median nPSA in patients in remission was 0.51 ng/mL (0.01 - 8.5). Patients attaining a low PSA nadir had a significant higher BFFF (p<0.05). Median D90 in patients with biochemical relapse was 87.2 Gy (51 - 143,1). Patients receiving a high D90 had a significant higher BFFF (p<0.05).
  
  
  CONCLUSIONS
  In a well selected patient population, LDR brachytherapy offers excelente outcomes. Reaching a low PSA nadir and attaining high D90 values are significant predictors for a higher DFS.
authors.affiliation: Department of Urology, AZ St Lucas, Ghent, Oost-Vlaanderen, Belgium.
authors.forename: Pieter
authors.initials: P
authors.lastname: Logghe
authors.affiliation: Department of Urology, AZ St Lucas, Ghent, Oost-Vlaanderen, Belgium.
authors.forename: Rolf
authors.initials: R
authors.lastname: Verlinde
authors.affiliation: Department of Radiotherapy-Oncology, AZ St Lucas, Ghent, Oost-Vlaanderen, Belgium.
authors.forename: Frank
authors.initials: F
authors.lastname: Bouttens
authors.affiliation: Department of Pathology, AZ St Lucas, Ghent, Oost-Vlaanderen, Belgium.
authors.forename: Caroline
authors.initials: C
authors.lastname: Van den Broecke
authors.affiliation: Department of Physics, AZ St Lucas, Ghent, Oost-Vlaanderen, Belgium.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Deman
authors.affiliation: Department of Physics, AZ St Lucas, Ghent, Oost-Vlaanderen, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Verboven
authors.affiliation: Department of Urology, AZ St Lucas, Ghent, Oost-Vlaanderen, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Maes
authors.affiliation: Department of Urology, AZ St Lucas, Ghent, Oost-Vlaanderen, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Merckx
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects*; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage* / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D012007:Rectum / Q000528:radiation effects; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014521:Urethra / Q000528:radiation effects; D001743:Urinary Bladder / Q000528:radiation effects
chemical_list: D007457:Iodine Radioisotopes; D017430:Prostate-Specific Antigen
keywords: Brachytherapy; Prostate-Specific Antigen; Prostatic Neoplasms