A single institution analysis of low-dose-rate brachytherapy: 5-year reported survival and late toxicity outcomes

Michael Chao; Sandra Spencer; Mario Guerrieri; Wei Ding; Mehran Goharian; Huong Ho; Michael Ng; Danielle Healey; Alwin Tan; Chee Cham; Daryl Lim Joon; Nathan Lawrentschuk; Douglas Travis; Shomik Sengupta; Yee Chan; Andrew Troy; Trung Pham; David Clarke; Peter Liodakis; Damien Bolton

doi:10.5114/jcb.2018.75600

eISSN: 2081-2841
ISSN: 1689-832X

Journal of Contemporary Brachytherapy

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abstract:

Review paper

A single institution analysis of low-dose-rate brachytherapy: 5-year reported survival and late toxicity outcomes

Michael Chao

,

Sandra Spencer

,

Mario Guerrieri

,

Wei Ding

,

Mehran Goharian

,

Huong Ho

,

Michael Ng

,

Danielle Healey

,

Alwin Tan

,

Chee Cham

,

Daryl Lim Joon

,

Nathan Lawrentschuk

,

Douglas Travis

,

Shomik Sengupta

,

Yee Chan

,

Andrew Troy

,

Trung Pham

,

David Clarke

,

Peter Liodakis

,

Damien Bolton

J Contemp Brachytherapy 2018; 10, 2: 155–161

DOI: https://doi.org/10.5114/jcb.2018.75600

Online publish date: 2018/04/30

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AMA

Chao M, Spencer S, Guerrieri M, et al. A single institution analysis of low-dose-rate brachytherapy: 5-year reported survival and late toxicity outcomes. Journal of Contemporary Brachytherapy. 2018;10(2):155-161. doi:10.5114/jcb.2018.75600.

APA

Chao, M., Spencer, S., Guerrieri, M., Ding, W., Goharian, M.,  & Ho, H. et al. (2018). A single institution analysis of low-dose-rate brachytherapy: 5-year reported survival and late toxicity outcomes. Journal of Contemporary Brachytherapy, 10(2), 155-161. https://doi.org/10.5114/jcb.2018.75600

Chicago

Chao, Michael, Sandra Spencer, Mario Guerrieri, Wei Ding, Mehran Goharian, Huong Ho,  and Michael Ng et al. 2018. "A single institution analysis of low-dose-rate brachytherapy: 5-year reported survival and late toxicity outcomes". Journal of Contemporary Brachytherapy 10 (2): 155-161. doi:10.5114/jcb.2018.75600.

Harvard

Chao, M., Spencer, S., Guerrieri, M., Ding, W., Goharian, M., Ho, H., Ng, M., Healey, D., Tan, A., Cham, C., Joon, D., Lawrentschuk, N., Travis, D., Sengupta, S., Chan, Y., Troy, A., Pham, T., Clarke, D., Liodakis, P.,  and Bolton, D. (2018). A single institution analysis of low-dose-rate brachytherapy: 5-year reported survival and late toxicity outcomes. Journal of Contemporary Brachytherapy, 10(2), pp.155-161. https://doi.org/10.5114/jcb.2018.75600

MLA

Chao, Michael et al. "A single institution analysis of low-dose-rate brachytherapy: 5-year reported survival and late toxicity outcomes." Journal of Contemporary Brachytherapy, vol. 10, no. 2, 2018, pp. 155-161. doi:10.5114/jcb.2018.75600.

Vancouver

Chao M, Spencer S, Guerrieri M, Ding W, Goharian M, Ho H et al. A single institution analysis of low-dose-rate brachytherapy: 5-year reported survival and late toxicity outcomes. Journal of Contemporary Brachytherapy. 2018;10(2):155-161. doi:10.5114/jcb.2018.75600.

Purpose
To report the 5-year biochemical relapse-free survival (BRFS), overall survival (OS), and long-term toxicity outcomes of patients treated with low-dose-rate (LDR) brachytherapy as monotherapy for low- to intermediate-risk prostate cancer.

Material and methods
Between 2004 and 2011, 371 patients were treated with LDR brachytherapy as monotherapy. Of these, 102 patients (27%) underwent transurethral resection of the prostate (TURP) prior to implantation. Follow-up was performed every 3 months for 12 months, then every 6 months over 4 years and included prostate specific antigen evaluation. The biochemical relapse-free survival (BRFS) was defined according to the Phoenix criteria. Acute and late toxicities were documented using the Common Terminology Criteria for Adverse Events version 4.0. The BRFS and OS estimates were calculated using Kaplan-Meier plots. Univariate and multivariate analyses were performed to evaluate outcomes by pre-treatment clinical prognostic factors and radiation dosimetry.

Results
The median follow-up of all patients was 5.45 years. The 5-year BRFS and OS rates were 95% and 96%, respectively. The BRFS rates for patients with Gleason score (GS) > 7 and GS ≤ 6 were 96% and 91% respectively (p = 0.06). On univariate analysis, T1 and T2 staging, risk-group classification, and prostate volumes had no impact on survival at 5 years (p > 0.1). Late grade 2 and 3 genitourinary (GU) toxicities were observed in 10% and 5% of patients respectively. Additionally, patients with prior TURP had a greater incidence of late grade 2 or 3 urinary retention (p = 0.001). There were 14 deaths in total; however, none were attributed to prostate cancer.

Conclusions
LDR brachytherapy is an effective treatment option in low- to intermediate-risk prostate cancer patients. We observed low biochemical relapse rates and minimal GU toxicities several years after treatment in patients with or without TURP. However, a small risk of urinary retention was observed in some patients.

keywords:

A single institution analysis of low-dose-rate brachytherapy: 5-year reported survival and late toxicity outcomes

brachytherapy, prostatic neoplasms, transurethral resection of prostate