Biochemical control in intermediate- and high-risk prostate cancer after EBRT with and without brachytherapy boost.
Strahlenther Onkol
; 2024 Jun 03.
Article
in En
| MEDLINE
| ID: mdl-38829436
ABSTRACT
PURPOSE:
External beam radiotherapy (EBRT) with or without brachytherapy boost (BTB) has not been compared in prospective studies using guideline-recommended radiation dose and recommended androgen-deprivation therapy (ADT). In this multicenter retrospective analysis, we compared modern-day EBRT with BTB in terms of biochemical control (BC) for intermediate-risk (IR) and high-risk (HR) prostate cancer.METHODS:
Patients were treated for primary IR or HR prostate cancer during 1999-2019 at three high-volume centers. Inclusion criteria were prescribed ≥â¯76â¯Gy EQD2 (α/ßâ¯= 1.5â¯Gy) for IR and ≥â¯78â¯Gy EQD2 (α/ßâ¯= 1.5â¯Gy) for HR as EBRT alone or with BTB. All HR patients received ADT and pelvic irradiation, which were optional in IR cases. BC between therapies was compared in survival analyses.RESULTS:
Of 2769 initial patients, 1176 met inclusion criteria 468 HR (260 EBRT, 208 BTB) and 708 IR (539 EBRT, 169 BTB). Median follow-up was 49 and 51 months for HR and IR, respectively. BTB patients with ≥â¯113â¯Gy EQD2Gy experienced a stable, good BC outcome compared with BTB at lower doses. Patients treated with ≥â¯113â¯Gy EQD2Gy also experienced significantly improved BC compared with EBRT (10-year BC failure rates after ≥â¯113â¯Gy BTB and EBRT respectively 20.4 and 41.8% for HR and 7.5 and 20.8% for IR).CONCLUSIONS:
In patients with IR and HR prostate cancer, BTB with ≥â¯113â¯Gy EQD2Gy offered a BC advantage compared with dose-escalated EBRT and lower BTB doses.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
Strahlenther Onkol
Journal subject:
NEOPLASIAS
/
RADIOTERAPIA
Year:
2024
Document type:
Article
Affiliation country:
Austria
Country of publication:
Alemania