Permanent prostate brachytherapy with or without supplemental external beam radiotherapy as practiced in Japan: Outcomes of 1300 patients

Atsunori Yorozu, Nobuko Kuroiwa, Akane Takahashi, Kazuhito Toya, Shiro Saito, Toru Nishiyama, Yasuto Yagi, Tomoki Tanaka, Yutaka Shiraishi, Toshio Ohashi

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Purpose: To report outcomes for men treated with iodine-125 (125I) prostate brachytherapy (BT) at a single institution in Japan. Methods and Materials: Between 2003 and 2009, 1313 patients (median age, 68years) with clinically localized prostate cancer were treated with 125I BT. Median prostate-specific antigen level was 7.6ng/mL (range, 1.1-43.3). T-stage was T1c in 60%, T2 in 39%, and T3 in 1% of patients. The Gleason score was <7, 7, and >7 in 49%, 45%, and 6% of patients, respectively. Neoadjuvant androgen deprivation therapy was used in 40% of patients and combined external beam radiotherapy of 45Gy in 48% of patients. Postimplant dosimetry was performed after 30days after implantation, with total doses converted to the biologically effective dose. Survival functions were calculated by the Kaplan-Meier method and Cox hazard model. Results: Median followup was 67months (range, 6-126). The 7-year biochemical freedom from failure for low-, intermediate-, and selected high-risk prostate cancers were 98%, 93%, and 81%, respectively (. p<0.001). Multivariate analysis identified the Gleason score, initial prostate-specific antigen level, positive biopsy rate, dose, and neoadjuvant androgen deprivation therapy as predictors for biochemical freedom from failure. The 7-year actuarial developing Grade 3+ genitourinary and gastrointestinal toxicity was 2% and 0.3%, respectively. Forty-four percent patients with normal baseline potency retained normal erectile function at 5years. Conclusions: 125I prostate BT is a highly effective treatment option for low-, intermediate-, and selected high-risk prostate cancers. Side effects were tolerable. An adequate dose may be required to achieve successful biochemical control.

Original languageEnglish
Pages (from-to)111-117
Number of pages7
JournalBrachytherapy
Volume14
Issue number2
DOIs
Publication statusPublished - 2015 Mar 1

Keywords

  • Brachytherapy
  • Dose-response
  • Iodine-125
  • Low-dose-rate
  • Permanent seed implantation
  • Prostate cancer
  • Radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

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