High-dose-rate (2 fractions of 13.5 Gy) and low-dose-rate brachytherapy as monotherapy in prostate cancer. Long term outcomes and predictive value of nadir prostate-specific antigen

IF 1.7 4区医学 Q4 ONCOLOGY

Brachytherapy Pub Date : 2025-03-01 DOI:10.1016/j.brachy.2024.10.014

Silvia Rodríguez Villalba , Diana Guevara Barrera , Luis Suso-Martí , Enrique Sanchis-Sánchez , Jose Pérez-Calatayud , Jose Domingo Lago Martín , Francisco Blázquez Molina , Manuel Santos Ortega

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引用次数: 0

Abstract

Purpose

This study aims to evaluate the outcomes of patients treated for low-risk (LR) and favorable intermediate risk (FIR) prostate cancer with brachytherapy (BT) in monotherapy with LDR or HDR and its relationship with nadir PSA (nPSA).

Materials and Methods

We retrospectively analyzed 139 patients (2005-2019) with exclusive LDR (46%. 145/160 Gy) /HDR (54%. 2 implants of 13.5 Gy each separated 10 days). 69% LR and 31% FIR. PSA nadir was grouped into two categories: ≤ 0.2 ng/mL and > 0.2 ng/mL.

Results

Median patient age was 69 years (46-84). Seventy-six patients (55%) received androgen deprivation therapy, and 37% received neoadjuvant therapy. Median follow-up period was 90 months. Actuarial biochemical failure-free survival (BFFS), local control (LC), overall survival (OS), and cause-specific survival (CSS) rates for the total cohort were 78%, 87%, 68%, and 98% at 10 years, respectively. BFFS, LC, OS and CSS in nPSA ≤ 0,2 ng/ml was 90%, 96%, 67%, 100% at 10 years respectively, whereas, those with a nPSA > 0.2 ng/ml had a BFFS, LC, OS and CSS of was 37%, 51%, 72%, 90% at 10 years respectively Statistical significance between both groups was reached in BFFS (p=0,000), LC (p=0,000) and CSS (p=0,007)). In the univariate analysis, there was no difference between risk stratification, BT technique, ADT, or the development of bouncing.

Conclusions

Prostate brachytherapy as monotherapy (LDR and HDR) is an effective treatment option for patients with LR and FIR prostate cancer. nPSA ≤0,2 ng/ml is a representative value that provides prognostic information for favorable outcomes in this group of patients.

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高剂量率（2 次，每次 13.5 Gy）和低剂量率近距离放射治疗作为前列腺癌的单一疗法。前列腺特异性抗原最低值的长期疗效和预测价值。

目的：本研究旨在评估低风险（LR）和中度风险（FIR）前列腺癌患者接受近距离放射治疗（BT）（LDR或HDR单药治疗）后的疗效，以及其与血中PSA（nPSA）的关系：我们回顾性分析了139例（2005-2019年）接受LDR（46%，145/160 Gy）/HDR（54%，2次植入，每次13.5 Gy，间隔10天）单次治疗的患者。69%为LR，31%为FIR。PSA nadir分为两类：≤ 0.2 ng/mL和> 0.2 ng/mL：患者年龄中位数为 69 岁（46-84 岁）。76名患者（55%）接受了雄激素剥夺治疗，37%接受了新辅助治疗。中位随访期为 90 个月。整个组群的精算无生化失败生存率（BFFS）、局部控制率（LC）、总生存率（OS）和病因特异性生存率（CSS）在10年后分别为78%、87%、68%和98%。nPSA ≤ 0.2 ng/ml 的患者 10 年后的 BFFS、LC、OS 和 CSS 分别为 90%、96%、67% 和 100%，而 nPSA > 0.2 ng/ml 的患者 10 年后的 BFFS、LC、OS 和 CSS 分别为 37%、51%、72% 和 90%，两组患者的 BFFS（P=0,000）、LC（P=0,000）和 CSS（P=0,007）均有统计学意义。）在单变量分析中，风险分层、BT 技术、ADT 或反弹发生率之间没有差异：前列腺近距离放射治疗作为一种单一疗法（LDR 和 HDR）是前列腺癌 LR 和 FIR 患者的有效治疗选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brachytherapy 医学-核医学

CiteScore

3.40

自引率

21.10%

发文量

119

审稿时长

9.1 weeks

期刊介绍： Brachytherapy is an international and multidisciplinary journal that publishes original peer-reviewed articles and selected reviews on the techniques and clinical applications of interstitial and intracavitary radiation in the management of cancers. Laboratory and experimental research relevant to clinical practice is also included. Related disciplines include medical physics, medical oncology, and radiation oncology and radiology. Brachytherapy publishes technical advances, original articles, reviews, and point/counterpoint on controversial issues. Original articles that address any aspect of brachytherapy are invited. Letters to the Editor-in-Chief are encouraged.