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Outcomes after PD-103 versus I-125 for low dose rate prostate brachytherapy monotherapy: An international, multi-institutional study.
Tang, Chad; Sanders, Jeremiah; Thames, Howard; Swanson, David M; Crook, Juanita M; Bruno, Teresa; Blanchard, Pierre; Ciezki, Jay; Keyes, Mira; Song, Daniel; Singh, Tanmay; Merrick, Gregory; Stock, Richard; Sullivan, Francis J; Mok, Henry; Millar, Jeremy; Frank, Steven J.
Afiliação
  • Tang C; The University of Texas MD Anderson Cancer Center, Houston, TX, USA. Electronic address: ctang1@mdanderson.org.
  • Sanders J; The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Thames H; The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Swanson DM; The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Crook JM; BC Cancer, University of British Columbia, Canada.
  • Bruno T; The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Blanchard P; Institut Gustave Roussy, Paris, France.
  • Ciezki J; Cleveland Clinic, Cleveland, OH, USA.
  • Keyes M; BC Cancer, University of British Columbia, Canada.
  • Song D; Johns Hopkins University, Baltimore, MD, USA.
  • Singh T; Johns Hopkins University, Baltimore, MD, USA.
  • Merrick G; Urologic Research Institute, Wheeling, WV, USA.
  • Stock R; Mt Sinai School of Medicine, NY, NY, USA.
  • Sullivan FJ; Galway Clinic, Galway, Ireland.
  • Mok H; The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • Millar J; Alfred Health, Melbourne, Australia.
  • Frank SJ; The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Radiother Oncol ; 183: 109599, 2023 06.
Article em En | MEDLINE | ID: mdl-36889593
BACKGROUND AND PURPOSE: Pd-103 and I-125 are commonly used in low dose rate (LDR) brachytherapy for prostate cancer. Comparisons of outcomes by isotope type are limited, but Pd-103 has distinct radiobiologic advantages over I-125 despite its lesser availability outside the United States. We evaluated oncologic outcomes after Pd-103 vs I-125 LDR monotherapy for prostate cancer. MATERIALS AND METHODS: We retrospectively analyzed databases at 8 institutions for men who received definitive LDR monotherapy with Pd-103 (n = 1,597) or I-125 (n = 7,504) for prostate cancer. Freedom from clinical failure (FFCF) and freedom from biochemical failure (FFBF) stratified by isotope were analyzed by Kaplan-Meier univariate and Cox multivariate analyses. Biochemical cure rates (prostate-specific antigen level ≤ 0.2 ng/mL between 3.5 and 4.5 years of follow-up) by isotype were calculated for men with at least 3.5 years of follow-up and compared by univariate and multivariate logistic regression. RESULTS: Compared with I-125, Pd-103 led to higher 7-year rates of FFBF (96.2% vs 87.6%, P < 0.001) and FFCF (96.5% vs 94.3%, P < 0.001). This difference held after multivariate adjustment for baseline factors (FFBF hazard ratio [HR] = 0.31, FFCF HR = 0.49, both P < 0.001). Pd-103 was also associated with higher cure rates on univariate (odds ratio [OR] = 5.9, P < 0.001) and multivariate (OR = 6.0, P < 0.001) analyses. Results retained significance in sensitivity analyses of data from the 4 institutions that used both isotopes (n = 2,971). CONCLUSIONS: Pd-103 monotherapy was associated with higher FFBF, FFCF, and biochemical cure rates, and suggests that Pd-103 LDR may lead to improved oncologic outcomes compared with I-125.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Braquiterapia Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Male Idioma: En Revista: Radiother Oncol Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Braquiterapia Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans / Male Idioma: En Revista: Radiother Oncol Ano de publicação: 2023 Tipo de documento: Article