Impact of comorbidity in elderly prostate cancer patients treated with brachytherapy

摘要

Objective:To analyze the correlations among comorbidity and overall survival (OS),biochemical progression-free survival (b-PFS) and toxicity in elderly patents with localized prostate cancer treated with 125I brachytherapy.Methods:Elderly men,aged ≥65 years,with low-intermediate risk prostate cancer,were treated with permanent 125I brachytherapy as monotherapy.Comorbidity data were obtained from medical reports using age-adjusted Charlson comorbidity index (a-CCI).The patients were categorized into two age groups (＜75and ≥75 years old),and two comorbidity score groups (a-CCI ≤3 and ＞3).Toxicity was scored with Radiation Therapy Oncology Group (RTOG) scale.Results:From June 2003 to October 2009,a total of 92 elderly patients underwent prostate brachytherapy,including 57 men (62％) with low-risk prostate cancer,and 35 men (38％) with intermediate-risk prostate cancer.The median age of patients was 75 years (range,65-87 years).Forty-seven patients (51％) had a-CCI ≤3 and 45 patients (49％) a-CCI ＞3.With a median follow-up period of 56 months (range,24-103 months),the 5-year actuarial OS and b-PFS were 91.3％ and 92.4％ respectively,without statistical significance between two Charlson score groups.Toxicity was mild.None of the patients experienced gastrointestinal (GI) toxicity,and only 4 patiens (4％) experienced late genitourinary (GU) grade-3 (G3) toxicity.No correlation between acute GU and GI toxicity and comorbidity was showed (P=0.50 and P=0.70,respectively).Conclusions:Our data suggest that elderly men with low-intermediate risk prostate cancer and comorbidity can be considered for a radical treatment as 125I low-dose rate brachytherapy.