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Ten‐year outcomes using low dose rate brachytherapy for localised prostate cancer: An update to the first Australian experience
Author(s) -
Wilson Craig,
Waterhouse David,
Lane Stephen E,
Haworth Annette,
Stanley John,
Shan Tom,
Joseph David
Publication year - 2016
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12453
Subject(s) - medicine , common terminology criteria for adverse events , prostate cancer , brachytherapy , urology , prostate specific antigen , cohort , radiation therapy , cancer , prostate , univariate analysis , multivariate analysis , surgery
To report long‐term prostate‐specific antigen ( PSA ) and toxicity outcomes for patients with localised prostate cancer treated with Iodine‐125 permanent implantation at a single Australian centre. Methods Between September 1994 and November 2007, 207 patients at Sir Charles Gairdner Hospital with localised prostate cancer were consecutively treated with Iodine‐125 permanent interstitial implantation. Post‐therapy assessment was performed three times a month and included clinical review and biochemical ( PSA ) evaluation. PSA progression was evaluated using the Phoenix (nadir + 2.0) definition. Treatment‐related morbidity was assessed using the Common Terminology Criteria for Adverse Events ( CTCAE ) version 3.0 guidelines. The rate of biochemical failure was calculated by Kaplan–Meier plots. Univariate and multivariate analyses were performed to evaluate outcomes by pre‐treatment clinical prognostic factors and radiation dosimetry. Results Median follow‐up was 7.8 years. The 10‐year biochemical disease‐free survival ( bDFS ) for the entire cohort was 89%. Ten‐year bDFS estimates by pre‐treatment risk group were 96% for low‐risk, 83% for intermediate‐risk and 50% for high‐risk disease. On multivariate analysis, pre‐treatment PSA was an independent predictor of bDFS . D90 dose did not show a statistically significant effect on bDFS . The peak incidences of late grade 3 or higher urinary and rectal toxicities were 10.7% and 1.1% respectively. Conclusion Excellent long‐term biochemical control was demonstrated with Iodine‐125 permanent interstitial implantation in appropriately selected patients with prostate cancer. The results of our single centre experience are comparable with those of other single institutions.