High–intermediate prostate cancer treated with low-dose-rate brachytherapy with or without androgen deprivation therapy

摘要

Abstract Purpose To describe outcomes of men with unfavorable (high-tier) intermediate risk prostate cancer (H-IR) treated with low-dose-rate (LDR) brachytherapy, with or without 6 onths of androgen deprivation therapy (ADT). Methods and Materials Patients with H-IR prostate cancer, treated before 2012 with LDR brachytherapy without external radiation are included. Baseline tumor characteristics are described. Outcomes between groups receiving ADT are measured by Phoenix (nadir?g/mL), and threshold 0.4g/mL biochemical relapse definitions (bNEDs), as well as clinical end points. Standard descriptive and actuarial statistics are used. Results Two hundred sixty men were eligible, 139 (53%) did not receive ADT and 121 (47%) did. Median follow-up was 5ears. Men treated with ADT had higher T stage and percent positive cores but lower pathologic grade group. bNED rates with and without ADT at 5ears are 86% and 85% ( p ?0.52) with the Phoenix definition, and 83% and 78% ( p ?0.13) with the threshold definition. Local recurrence or metastasis were rare in both groups ( p ?ot significant). Death from prostate cancer only occurred in 4 patients, 2 in each group. Overall survival was 85% in those treated with ADT and 93% without at 8ears, p ?0.15. Conclusions The addition of 6 onths of ADT to LDR brachytherapy for H-IR prostate cancer does not improve 5ear prostate specific antigen control, and we no longer routinely recommended it.