Abstract
Objective
The aim of the study is to compare the results of the combined external beam radiotherapy
(EBRT) with iodine-125 seed brachytherapy vs. brachytherapy alone for prostate cancer
treatment in patients with intermediate and high risk of disease recurrence.
Methods and Materials
Ninety-six patients were treated from January 1998 to December 2006. Twenty-four patients
received combined treatment and 72 patients received brachytherapy alone. Patients
were classified into intermediate or high risk of recurrence according to the D’Amico’s
classification. The prescribed dose for brachytherapy was 145 Gy as monotherapy and 110 Gy for combined treatment. The dose of EBRT was 45 Gy over 5 weeks, with 1.8 Gy daily fractions. Results were analyzed based on Phoenix definition of biochemical
recurrence, that is, nadir plus 2 ng/mL.
Results
Biochemical control was achieved by 96% (23 of 24) of patients receiving combined
treatment and by 72% (52 of 72) in the group treated by brachytherapy alone (p<0.015). The addition of EBRT resulted in a 94% biochemical disease-free survival at
5 years; and in brachytherapy alone group, the rate was 54% (p<0.011). Mean followup was 96 months (24–132 months; confidence interval 95%: 90–102).
Conclusion
This study shows that in patients with localized prostate cancer, with intermediate
and high risk of biochemical recurrence, the addition of EBRT can confer a significant
biochemical control advantage when added to brachytherapy.
Keywords
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Article Info
Publication History
Published online: August 16, 2010
Accepted:
July 16,
2009
Received in revised form:
July 15,
2009
Received:
September 10,
2008
Footnotes
This work was performed by Brazilian Institute of Oncology (IBO)—Radioterapia Botafogo, Pontifical Catholic University of Rio de Janeiro(PUCRJ), and Clementino Fraga Filho University Hospital of Rio de Janeiro Federal University. IBO was the sponsor for the expenses involved in the edition of this article.
Identification
Copyright
© 2010 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- In regards to Da Silva Franca et al.: “Localized prostate cancer with intermediate- or high-risk features treated with combined external beam radiotherapy and iodine-125 seed brachytherapy” (Brachytherapy 2010; 9(4): 307-312)BrachytherapyVol. 13Issue 5
- PreviewFirst, we would like to congratulate the authors Da Silva Franca et al. (1) for a very good compilation and honest representation of their prostate brachytherapy data. We take great interest in reading the article that retrospectively compares biochemical control rates of brachytherapy vs. the combination of brachytherapy with external beam radiotherapy (EBRT) for intermediate- or high-risk localized prostate cancer. The article concludes saying improved biochemical control rates with addition of EBRT shows significant advantage when added to brachytherapy.
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- Response to Drs Patil and D'SouzaBrachytherapyVol. 13Issue 5
- PreviewBrachytherapy treatment method is rarely prescribed in our country because of the high cost of the 125I seeds for a low income society and also because most of our patients present with very advanced clinical stage of the disease. The Brazilian National Cancer Institute forecast for 2014 a total of 68,800 new cases of prostate cancer (1) and only 1.5% could be submitted to low-dose brachytherapy treatment.
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