Actuarial disease-free survival after prostate cancer brachytherapy using interactive techniques with biplane ultrasound and fluoroscopic guidance

Gordon L. Grado, Thayne R. Larson, Carrie S. Balch, Mary M. Grado, Joseph M. Collins, J. Scott Kriegshauser, Gregory P Swanson, Roberta J. Navickis, Mahlon M. Wilkes

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

Purpose: To evaluate the effectiveness and safety of interactive transperineal brachytherapy under biplane ultrasound and fluoroscopic guidance in patients with localized prostate cancer. Methods and Materials: Brachytherapy using 125I or 103Pd radioactive seeds either alone or in combination with adjunctive external beam radiotherapy (XRT) was administered to 490 patients at a single institution. Post-treatment follow-up included clinical assessment of disease status, assays of serum prostate-specific antigen (PSA) levels and documentation of treatment-related symptoms and complications. Results: Actuarial disease-free survival at 5 yr was 79% (95% CI, 71-85%), and the 5-yr actuarial rate of local control was 98% (95% CI, 94-99%). Post-treatment PSA nadir and pretreatment PSA level were found to be significant predictors of disease-free survival. In patients with a PSA nadir < 0.5 ng/ml, 5-yr disease-free survival was 93% (95% CI, 84-97%), compared with 25% (95% CI, 5-53%) in patients whose PSA nadir was 0.5-1.0 ng/ml and 15% (95% CI, 3-38) in patients with a PSA nadir > 1.0 ng/ml. Brachytherapy was well tolerated with few post-treatment complications. Conclusion: A broad range of patients with localized prostate cancer can benefit from transperineal brachytherapy with minimal morbidity. A post-treatment PSA nadir below 0.5 ng/ml provides a useful prognostic indicator of favorable long-term outcome.

Original languageEnglish (US)
Pages (from-to)289-298
Number of pages10
JournalInternational Journal of Radiation Oncology Biology Physics
Volume42
Issue number2
DOIs
StatePublished - Sep 1 1998
Externally publishedYes

Fingerprint

biplanes
Brachytherapy
antigens
Prostate-Specific Antigen
Disease-Free Survival
Prostatic Neoplasms
cancer
Therapeutics
documentation
Documentation
pretreatment
serums
seeds
radiation therapy
safety
Seeds
Radiotherapy
Morbidity
Safety
predictions

Keywords

  • Brachytherapy
  • Iodine
  • Palladium
  • Prostate carcinoma
  • Prostate-specific antigen

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Actuarial disease-free survival after prostate cancer brachytherapy using interactive techniques with biplane ultrasound and fluoroscopic guidance. / Grado, Gordon L.; Larson, Thayne R.; Balch, Carrie S.; Grado, Mary M.; Collins, Joseph M.; Kriegshauser, J. Scott; Swanson, Gregory P; Navickis, Roberta J.; Wilkes, Mahlon M.

In: International Journal of Radiation Oncology Biology Physics, Vol. 42, No. 2, 01.09.1998, p. 289-298.

Research output: Contribution to journalArticle

Grado, Gordon L. ; Larson, Thayne R. ; Balch, Carrie S. ; Grado, Mary M. ; Collins, Joseph M. ; Kriegshauser, J. Scott ; Swanson, Gregory P ; Navickis, Roberta J. ; Wilkes, Mahlon M. / Actuarial disease-free survival after prostate cancer brachytherapy using interactive techniques with biplane ultrasound and fluoroscopic guidance. In: International Journal of Radiation Oncology Biology Physics. 1998 ; Vol. 42, No. 2. pp. 289-298.
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abstract = "Purpose: To evaluate the effectiveness and safety of interactive transperineal brachytherapy under biplane ultrasound and fluoroscopic guidance in patients with localized prostate cancer. Methods and Materials: Brachytherapy using 125I or 103Pd radioactive seeds either alone or in combination with adjunctive external beam radiotherapy (XRT) was administered to 490 patients at a single institution. Post-treatment follow-up included clinical assessment of disease status, assays of serum prostate-specific antigen (PSA) levels and documentation of treatment-related symptoms and complications. Results: Actuarial disease-free survival at 5 yr was 79{\%} (95{\%} CI, 71-85{\%}), and the 5-yr actuarial rate of local control was 98{\%} (95{\%} CI, 94-99{\%}). Post-treatment PSA nadir and pretreatment PSA level were found to be significant predictors of disease-free survival. In patients with a PSA nadir < 0.5 ng/ml, 5-yr disease-free survival was 93{\%} (95{\%} CI, 84-97{\%}), compared with 25{\%} (95{\%} CI, 5-53{\%}) in patients whose PSA nadir was 0.5-1.0 ng/ml and 15{\%} (95{\%} CI, 3-38) in patients with a PSA nadir > 1.0 ng/ml. Brachytherapy was well tolerated with few post-treatment complications. Conclusion: A broad range of patients with localized prostate cancer can benefit from transperineal brachytherapy with minimal morbidity. A post-treatment PSA nadir below 0.5 ng/ml provides a useful prognostic indicator of favorable long-term outcome.",
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AU - Grado, Gordon L.

AU - Larson, Thayne R.

AU - Balch, Carrie S.

AU - Grado, Mary M.

AU - Collins, Joseph M.

AU - Kriegshauser, J. Scott

AU - Swanson, Gregory P

AU - Navickis, Roberta J.

AU - Wilkes, Mahlon M.

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N2 - Purpose: To evaluate the effectiveness and safety of interactive transperineal brachytherapy under biplane ultrasound and fluoroscopic guidance in patients with localized prostate cancer. Methods and Materials: Brachytherapy using 125I or 103Pd radioactive seeds either alone or in combination with adjunctive external beam radiotherapy (XRT) was administered to 490 patients at a single institution. Post-treatment follow-up included clinical assessment of disease status, assays of serum prostate-specific antigen (PSA) levels and documentation of treatment-related symptoms and complications. Results: Actuarial disease-free survival at 5 yr was 79% (95% CI, 71-85%), and the 5-yr actuarial rate of local control was 98% (95% CI, 94-99%). Post-treatment PSA nadir and pretreatment PSA level were found to be significant predictors of disease-free survival. In patients with a PSA nadir < 0.5 ng/ml, 5-yr disease-free survival was 93% (95% CI, 84-97%), compared with 25% (95% CI, 5-53%) in patients whose PSA nadir was 0.5-1.0 ng/ml and 15% (95% CI, 3-38) in patients with a PSA nadir > 1.0 ng/ml. Brachytherapy was well tolerated with few post-treatment complications. Conclusion: A broad range of patients with localized prostate cancer can benefit from transperineal brachytherapy with minimal morbidity. A post-treatment PSA nadir below 0.5 ng/ml provides a useful prognostic indicator of favorable long-term outcome.

AB - Purpose: To evaluate the effectiveness and safety of interactive transperineal brachytherapy under biplane ultrasound and fluoroscopic guidance in patients with localized prostate cancer. Methods and Materials: Brachytherapy using 125I or 103Pd radioactive seeds either alone or in combination with adjunctive external beam radiotherapy (XRT) was administered to 490 patients at a single institution. Post-treatment follow-up included clinical assessment of disease status, assays of serum prostate-specific antigen (PSA) levels and documentation of treatment-related symptoms and complications. Results: Actuarial disease-free survival at 5 yr was 79% (95% CI, 71-85%), and the 5-yr actuarial rate of local control was 98% (95% CI, 94-99%). Post-treatment PSA nadir and pretreatment PSA level were found to be significant predictors of disease-free survival. In patients with a PSA nadir < 0.5 ng/ml, 5-yr disease-free survival was 93% (95% CI, 84-97%), compared with 25% (95% CI, 5-53%) in patients whose PSA nadir was 0.5-1.0 ng/ml and 15% (95% CI, 3-38) in patients with a PSA nadir > 1.0 ng/ml. Brachytherapy was well tolerated with few post-treatment complications. Conclusion: A broad range of patients with localized prostate cancer can benefit from transperineal brachytherapy with minimal morbidity. A post-treatment PSA nadir below 0.5 ng/ml provides a useful prognostic indicator of favorable long-term outcome.

KW - Brachytherapy

KW - Iodine

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KW - Prostate-specific antigen

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