Comparison between preoperative and real-time intraoperative planning 125I permanent prostate brachytherapy: Long-term clinical biochemical outcome

Haim Matzkin, Juza Chen, Larissa German, Nicola J. Mabjeesh

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Background: The purpose of the study is to evaluate the long-term clinical outcome through biochemical no evidence of disease (bNED) rates among men with low to intermediate risk prostate cancer treated with two different brachytherapy implant techniques: preoperative planning (PP) and real-time planning (IoP).Methods: From June 1998 to July 2011, 1176 men with median age of 67 years and median follow-up of 47 months underwent transperineal ultrasound-guided prostate 125I-brachytherapy using either PP (132) or IoP (1044) for clinical T1c-T2b prostate adenocarcinoma Gleason <8 and prostate-specific antigen (PSA) <20 ng/ml. Men with Gleason 7 received combination of brachytherapy, external beam radiation and 6-month androgen deprivation therapy (ADT). Biological effective dose (BED) was calculated using computerized tomography (CT)-based dosimetry 1-month postimplant. Failure was determined according to the Phoenix definition.Results: The 5- and 7-year actuarial bNED rate was 95% and 90% respectively. The 7-year actuarial bNED was 67% for the PP group and 95% for the IoP group (P < 0.001). Multivariate Cox regression analyses identified implant technique or BED, ADT and PSA as independent prognostic factors for biochemical failure.Conclusions: Following our previous published results addressing the limited and disappointing outcomes of PP method when compared to IoP based on CT dosimetry and PSA kinetics, we now confirm the long-term clinical, bNED rates clear cut superiority of IoP implant methodology.

Original languageEnglish
Article number288
JournalRadiation Oncology
Volume8
Issue number1
DOIs
StatePublished - 17 Dec 2013
Externally publishedYes

Keywords

  • Biochemical failure
  • Brachytherapy
  • Implant technique
  • Prostate cancer

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Fingerprint

Dive into the research topics of 'Comparison between preoperative and real-time intraoperative planning 125I permanent prostate brachytherapy: Long-term clinical biochemical outcome'. Together they form a unique fingerprint.

Cite this