TY - JOUR
T1 - Biochemical outcomes and predictive factors by risk group after permanent iodine-125 seed implantation
T2 - Prospective cohort study in 2,316 patients
AU - Katayama, Norihisa
AU - Nakamura, Katsumasa
AU - Yorozu, Atsunori
AU - Kikuchi, Takashi
AU - Fukushima, Masanori
AU - Saito, Shiro
AU - Dokiya, Takushi
N1 - Funding Information:
Financial disclosure: This research was in part supported by the Health Labor Sciences Research Grant (H29-ICT-Ippan-002)from the Ministry of Health, Labor, and Welfare in Japan.
Funding Information:
Financial disclosure: This research was in part supported by the Health Labor Sciences Research Grant (H29-ICT-Ippan-002) from the Ministry of Health, Labor, and Welfare in Japan.
Publisher Copyright:
© 2019 American Brachytherapy Society
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Purpose: To evaluate the biochemical freedom from failure (bFFF) by risk group and treatment modality and the predictive factors of bFFF by risk group in patients with prostate cancer undergoing permanent seed implantation (PI) with or without external beam radiation therapy (EBRT) in a nationwide prospective cohort study (Japanese Prostate Cancer Outcome Study of Permanent Iodine-125 [I-125] Seed Implantation) in Japan during the first 2 years. Methods and Materials: The analyses included 2,316 participants in 42 institutions; bFFF was evaluated using the Phoenix definition and calculated using the Kaplan–Meier method, and the Cox proportional hazards model was used to identify the factors associated with bFFF. Results: Median followup period was 60.0 months. The 5-year bFFF rates in all patients, 1,028 low-risk patients, 1,114 intermediate-risk patients, and 133 high-risk patients were 93.6%, 94.9%, 92.7%, and 91.1%, respectively. The 5-year bFFF rates in the PI group and EBRT combination therapy group were 93.7% and 93.3%, respectively. In a multivariate analysis, younger age, higher Gleason score (GS), higher percent positive biopsies (%PB), and lower prostate V100 (p = 0.0012, 0.0030, 0.0026, and 0.0368) in all patients; younger age, higher pretreatment prostate-specific antigen, and lower prostate V100 (p = 0.0002, 0.0048, and 0.0012) in low-risk patients; higher GS, higher %PB, and no hormonal treatment (p = 0.0005, 0.0120, and 0.0022) in intermediate-risk patients; and higher GS and higher %PB (p = 0.0329 and 0.0120) in high-risk patients were significantly associated with bFFF. Conclusions: PI with or without EBRT resulted in excellent short-term biochemical outcomes in all risk groups, especially in high-risk patients. Age, pretreatment prostate-specific antigen, and prostate V100 in low-risk patients; GS, %PB, and hormonal treatment in intermediate-risk patients; and GS and %PB in high-risk patients were independently affected bFFF.
AB - Purpose: To evaluate the biochemical freedom from failure (bFFF) by risk group and treatment modality and the predictive factors of bFFF by risk group in patients with prostate cancer undergoing permanent seed implantation (PI) with or without external beam radiation therapy (EBRT) in a nationwide prospective cohort study (Japanese Prostate Cancer Outcome Study of Permanent Iodine-125 [I-125] Seed Implantation) in Japan during the first 2 years. Methods and Materials: The analyses included 2,316 participants in 42 institutions; bFFF was evaluated using the Phoenix definition and calculated using the Kaplan–Meier method, and the Cox proportional hazards model was used to identify the factors associated with bFFF. Results: Median followup period was 60.0 months. The 5-year bFFF rates in all patients, 1,028 low-risk patients, 1,114 intermediate-risk patients, and 133 high-risk patients were 93.6%, 94.9%, 92.7%, and 91.1%, respectively. The 5-year bFFF rates in the PI group and EBRT combination therapy group were 93.7% and 93.3%, respectively. In a multivariate analysis, younger age, higher Gleason score (GS), higher percent positive biopsies (%PB), and lower prostate V100 (p = 0.0012, 0.0030, 0.0026, and 0.0368) in all patients; younger age, higher pretreatment prostate-specific antigen, and lower prostate V100 (p = 0.0002, 0.0048, and 0.0012) in low-risk patients; higher GS, higher %PB, and no hormonal treatment (p = 0.0005, 0.0120, and 0.0022) in intermediate-risk patients; and higher GS and higher %PB (p = 0.0329 and 0.0120) in high-risk patients were significantly associated with bFFF. Conclusions: PI with or without EBRT resulted in excellent short-term biochemical outcomes in all risk groups, especially in high-risk patients. Age, pretreatment prostate-specific antigen, and prostate V100 in low-risk patients; GS, %PB, and hormonal treatment in intermediate-risk patients; and GS and %PB in high-risk patients were independently affected bFFF.
KW - Biochemical failure
KW - Brachytherapy
KW - External beam radiation therapy
KW - Predictive factors
KW - Prostate cancer
KW - Risk group
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U2 - 10.1016/j.brachy.2019.03.008
DO - 10.1016/j.brachy.2019.03.008
M3 - Article
C2 - 31153759
AN - SCOPUS:85066265808
VL - 18
SP - 574
EP - 582
JO - Brachytherapy
JF - Brachytherapy
SN - 1538-4721
IS - 5
ER -
