Long-Term Efficacy and Toxicity of Low-Dose-Rate 125I Prostate Brachytherapy as Monotherapy in Low-, Intermediate-, and High-Risk Prostate Cancer
Long-Term Efficacy and Toxicity of Low-Dose-Rate 125I Prostate Brachytherapy as Monotherapy in Low-, Intermediate-, and High-Risk Prostate Cancer
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DOI：
10.1016/j.ijrobp.2015.02.047
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发表时间：
2015-07-15
影响因子：
7
通讯作者：
Ciezki, Jay P.
中科院分区：
文献类型：
--
作者：
Kittel, Jeffrey A.;Reddy, Chandana A.;Ciezki, Jay P.
目的/目标：报告单机构队列接受低剂量前列腺近距离放射治疗永久性植入物 (PI) 单一疗法的长期疗效和毒性。方法和材料：从 1996 年到 2007 年，对 1989 名低风险 (61.3%)、中风险 (29.8%)、高中风险 (4.5%) 和高风险前列腺癌 (4.4%) 患者进行了研究使用 PI 进行治疗并在登记处进行前瞻性随访。所有患者均接受 I-125 单一疗法至 144 Gy。根据修改后的不良事件通用术语标准 4.0 量表对晚期毒性进行回顾性编码。计算生化无复发生存率（bRFS）、无远处转移生存率（DMFS）、总生存率（OS）和前列腺癌特异性死亡率（PCSM）。我们确定了与晚期 >= 3 级泌尿生殖 (GU) 和胃肠道 (GI) 毒性、bRFS、DMFS、OS、PCSM 和失禁相关的因素。 结果：患者的中位年龄为 67 岁，中位总体随访时间和前列腺特异性抗原随访时间分别为 6.8 年和 5.8 年。 bRFS、DMFS、OS 和 PCSM 的总体 5 年率分别为 91.9%、97.8%、93.7% 和 0.71%。 10年比率分别为81.5%、91.5%、76.1%和2.5%。晚期>= 3 GU和胃肠道毒性的总体发生率分别为7.6%和0.8%。多变量分析显示，年龄和前列腺长度与晚期 >= 3 GU 毒性风险增加显着相关。失禁风险与 PI 前和 PI 后经尿道前列腺切除术高度相关。结论：前列腺近距离放射治疗作为单一疗法是低风险和低中风险前列腺癌的有效治疗方法，并且作为高中风险和高风险前列腺癌的治疗方法似乎很有前景。当近距离放射治疗作为单一治疗时，很少会出现严重的长期毒性。 (C) 2015 Elsevier Inc. 保留所有权利。
Purpose/Objectives: To report long-term efficacy and toxicity for a single-institution cohort of patients treated with low-dose-rate prostate brachytherapy permanent implant (PI) monotherapy.Methods and Materials: From 1996 to 2007, 1989 patients with low-risk (61.3%), intermediate-risk (29.8%), high-intermediate-risk (4.5%), and high-risk prostate cancer (4.4%) were treated with PI and followed up prospectively in a registry. All patients were treated with I-125 monotherapy to 144 Gy. Late toxicity was coded retrospectively according to a modified Common Terminology Criteria for Adverse Events 4.0 scale. The rates of biochemical relapse-free survival (bRFS), distant metastasis-free survival (DMFS), overall survival (OS), and prostate cancer-specific mortality (PCSM) were calculated. We identified factors associated with late grade >= 3 genitourinary (GU) and gastrointestinal (GI) toxicity, bRFS, DMFS, OS, PCSM, and incontinence.Results: The median age of the patients was 67 years, and the median overall and prostate-specific antigen follow-up times were 6.8 years and 5.8 years, respectively. The overall 5-year rates for bRFS, DMFS, OS, and PCSM were 91.9%, 97.8%, 93.7%, and 0.71%, respectively. The 10-year rates were 81.5%, 91.5%, 76.1%, and 2.5%, respectively. The overall rates of late grade >= 3 GU and GI toxicity were 7.6% and 0.8%, respectively. On multivariable analysis, age and prostate length were significantly associated with increased risk of late grade >= 3 GU toxicity. The risk of incontinence was highly correlated with both pre-PI and post-PI transurethral resection of the prostate.Conclusions: Prostate brachytherapy as monotherapy is an effective treatment for low-risk and low-intermediate-risk prostate cancer and appears promising as a treatment for high-intermediate-risk and high-risk prostate cancer. Significant long-term toxicities are rare when brachytherapy is performed as monotherapy. (C) 2015 Elsevier Inc. All rights reserved.