Long-term outcomes in patients younger than 60 years of age treated with brachytherapy for prostate cancer

  • Pedro J. Prada
  • Juan Cardenal
  • Ana García Blanco
  • Javier Anchuelo
  • María Ferri
  • Ivan Diaz de Cerio
  • Andrés Vázquez
  • Maite Pacheco
  • Samuel Ruiz Arrebola
Original Article

Abstract

Purpose

The purpose of the study was to report the outcomes and late toxicities in patients younger than 60 years of age with long-term follow-up treated with low dose rate (LDR) brachytherapy for localized prostate cancer.

Methods

Between January 2000 and December 2009, 270 consecutive patients were treated with favourable localized prostate cancer; the median follow-up was 111 months (range 21–206). All patients received one implant of LDR brachytherapy. Toxicity was reported according to the Common Toxicity Criteria for Adverse Events, Version 4.0 (CTAE v4.02) by the National Cancer Institute.

Results

The overall survival according to Kaplan–Meier estimates was 99 (±1%) at 17 years. The 17-year rate for failure in tumour-free survival (TFS) was 97% (±1%), whereas for biochemical control it was 95% (±1%) at 17 years, 97% (±1%) of patients being free of local recurrence. No intraoperative or perioperative complications occurred. Acute genitourinary (GU) grade II toxicity was 4% at 12 months. No other chronic toxicity was observed after treatment. At 6 months, 94% of patients reported no change in bowel function.

Conclusions

LDR brachytherapy provides patients younger than 60 years of age with low and intermediate-risk prostate cancer excellent outcomes and has a low risk of significant long-term GU or gastrointestinal morbidity.

Keywords

Brachytherapy Prostate cancer Younger patients Outcome Morbidity 

Abbreviations

AJCC

American Joint Committee on Cancer

BT

Brachytherapy

EBRT

External beam radiotherapy

CTAE v4.02

Common Toxicity Criteria for Adverse Event, version 4.02

D90

The dose that covers 90% volume of CTV

GI

Gastrointestinal

GU

Genitourinary

LDR

Low dose rate

PSA

Serum prostate-specific antigen

SPSS

Statistical analysis SPSS

SD

Standard deviations

TFS

Tumor-free survival

TG-43

Task group 43 (American Association of Physicist in Medicine)

TRUS

Transrectal ultrasound

Langzeitergebnisse einer Brachytherapie des Prostatakarzinoms bei Patienten unter 60 Jahren

Zusammenfassung

Zielsetzung

Ziel der Studie war es, im Langzeit-Follow-up die Behandlungsergebnisse und die Spättoxizität bei Patienten unter 60 Jahren, die eine niedrig dosierte Brachytherapie („low dose rate“ [LDR]) bei lokal begrenztem Prostatakarzinom erhielten, zu erfassen.

Methoden

Von Januar 2000 bis Dezember 2009 wurden 270 konsekutive Patienten mit günstig lokalisiertem Prostatakarzinom behandelt; die Follow-up-Dauer betrug im Median 111 Monate (Spanne 21–206 Monate). Jeder Patient erhielt ein Implantat für die LDR-Brachytherapie. Die Toxizität wurde gemäß den Common Toxicity Criteria for Adverse Events, Version 4.0 (CTCAE v4.02), des National Cancer Institute erfasst.

Ergebnisse

Das Gesamtüberleben nach einer Kaplan-Meier-Schätzung betrug 99 % (±1 %) nach 17 Jahren. Die 17-Jahres-Rate für das Versagen im tumorfreien Überleben lag bei 97 % (±1 %), die für die biochemische Kontrolle bei 95 % (±1 %) nach 17 Jahren, 97 % (±1 %) der Patienten hatten kein lokales Rezidiv. Intraoperative oder perioperative Komplikationen ereigneten sich nicht. Die urogenitale Grad-II-Toxizität betrug nach 12 Monaten 4 %. Eine anderweitige chronische Toxizität wurde nach der Behandlung nicht beobachtet. Nach 6 Monaten gaben 94% der Patienten keine Veränderungen in der Darmfunktion an.

Schlussfolgerungen

Mit der LDR-Brachytherapie werden bei Patienten unter 60 Jahren mit Low-risk- oder Intermediate-risk-Prostatakarzinom hervorragende Ergebnisse erzielt. Das Risiko einer signifikanten langfristigen Morbidität im urogenitalen oder gastrointestinalen Bereich ist gering.

Schlüsselwörter

Brachytherapie Prostatakrebs Jüngere Patienten Behandlungsergebnis Morbidität 

Notes

Conflict of interest

P.J. Prada, J. Cardenal, A. García Blanco, J. Anchuelo, M. Ferri, I. Diaz de Cerio, A. Vázquez, M. Pacheco and S. Ruiz Arrebola declare that they have no competing interests.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Pedro J. Prada
    • 1
  • Juan Cardenal
    • 1
  • Ana García Blanco
    • 1
  • Javier Anchuelo
    • 1
  • María Ferri
    • 1
  • Ivan Diaz de Cerio
    • 1
  • Andrés Vázquez
    • 2
  • Maite Pacheco
    • 2
  • Samuel Ruiz Arrebola
    • 2
  1. 1.Department of Radiation OncologyHospital Universitario Marqués de ValdecillaSantanderSpain
  2. 2.Department of Radiation PhysicsHospital Universitario Marqués de ValdecillaSantanderSpain

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