Author(s): Munro NP, AlQaisieh B, Bownes P, Smith J, Carey B,
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Abstract BACKGROUND AND PURPOSE: The effect of predominating Gleason grade (3+4 versus 4+3) in Gleason sum score (GS) 7 prostate cancer (PCa) on brachytherapy outcomes is unclear. The 10 year experience of permanent brachytherapy monotherapy at a single UK centre for GS 7, intermediate risk (Memorial Sloan-Kettering model), PSA < or = 10 ng/ml, localised PCa is reported. MATERIALS AND METHODS: Between 1995 and 2004, the outcomes of 187 patients with GS 7 PCa (PSA < or = 10 ng/ml) were analysed from a cohort of 1298 men treated with permanent Iodine-125 prostate brachytherapy, including PSA relapse-free survival (PSA-RFS). RESULTS: Median follow-up was 5.0 years (range 2.0-10.1 years). One patient has died of PCa. At 10 years, PSA-RFS was 82.4\%/78\% (ASTRO consensus and nadir +2 definitions). For GS 3+4, 5 year PSA-RFS was 86.7\%/87.9\% and for GS 4+3: 85.2\%/96.6\% respectively, with no significant difference between groups. Five year PSA-RFS (ASTRO) of 92.6\% was seen for D(90) > or = 140 Gy (50\% total), compared with 77.0\% below 140 Gy (p=0.08). CONCLUSIONS: Iodine-125 brachytherapy monotherapy achieved good rates of medium term biochemical control in GS 7, intermediate risk localised PCa patients. There was a trend to improved outcomes in men with a D90 in excess of 140 Gy. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
This article was published in Radiother Oncol
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