Abstract
PURPOSE
We evaluated the effect of age, <60 and ≥60 years, on biochemical outcomes and toxicities
in patients with prostate cancer who underwent permanent seed implantation (PI) ±
external beam radiation therapy ± hormone therapy in a national Japanese prospective
cohort study (J-POPS).
METHODS AND MATERIALS
The safety and efficacy analyses included 6721 and 6662 patients, respectively. We
categorized patients into two age groups: <60 (n = 716) and ≥60 (n = 6,005) years. We used propensity score matching (PSM) to estimate the marginal
effect of age on biochemical freedom from failure (bFFF) using a Phoenix definition
and Cox proportional hazard models.
RESULTS
The median followup period was 60.0 months. Without PSM, men <60 years demonstrated
similar 5-year bFFF (96.3%) compared with men ≥60 years (95.6%; p = 0.576); percent positive biopsies, biologically effective dose, Gleason score,
risk classification, and supplemental external beam radiation therapy (p <0.001, <0.001, <0.001, 0.008, and <0.001) were significantly associated with bFFF
while age was not (p = 0.576). With PSM, bFFF was not significantly different between age groups (p = 0.664); however, men <60 years showed a significantly lower incidence of declining
erectile function, grade ≥2 all urinary toxicities, urinary frequency/urgency, and
rectal bleeding (p <0.001, 0.024, 0.031, and 0.010) than men ≥60 years.
CONCLUSIONS
After PI, men <60 years achieved a comparable 5-year biochemical control rate and
showed a lower incidence of several toxicities compared to men ≥60 years. This suggests
that PI should be an excellent treatment option for men <60 years with prostate cancer.
Keywords
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Article info
Publication history
Published online: January 02, 2023
Accepted:
December 7,
2022
Received in revised form:
October 26,
2022
Received:
July 31,
2022
Publication stage
In Press Corrected ProofFootnotes
Disclosure: Part of this research was supported by a Grants-in-Aid for Scientific Research (C) (20K08049) from the Japan Society for the Promotion of Science. The authors declare that they have no conflicts of interest.
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© 2022 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
