Results of a cohort of 200 hormone-naïve consecutive patients with prostate cancer treated with iodine 125 permanent interstitial brachytherapy by the same multidisciplinary team.

ABSTRACT

PURPOSE: To report survival and morbidity of a cohort of 200 hormone-naïve consecutive patients with localized prostate cancer, treated by low-dose rate brachytherapy within the frame of multidisciplinary approach. PATIENTS AND METHODS: Between 2001 and 2011, 200 patients were treated by the same team with 125 iodine seeds 167 low-risk and 33 intermediate risk according to the d'Amico classification; eligible patients had clinical stage T1/T2a-b, Gleason score 3+3 or 3+4, baseline prostate-specific antigen level below 15ng/mL, prostate volume less than 60cm(3). The median number of random biopsies was 12 (range 6-32) and the breakdown of positive cores was as follows 1 (29%), 2 (35%), 3 or more (36%). Acute morbidity was assessed according to the Common Terminology Criteria for Adverse Events and late toxicity according to the EORTC/RTOG scale. Data were prospectively collected. RESULTS: The median follow-up was 69 months (range 16 to 135). The 5- and 10-year biochemical relapse free survivals were 95.6% (95% confidence interval [CI] 91-98) and 89.7% (95% CI 79.4-95.0). The 5-year and 10-year overall survival were respectively 96.4% (95% CI 92-98.4) and 89.7% (95% CI 80.8-94.6%) and the 10-year disease specific survival, 99.1% (95% CI 93.0-99.9). The 5- and 10-year grade 3 acute toxicity cumulative rate were respectively 3.3% (95% CI 1.4-6.6) and 4% (95% CI 1.4-6.6) and the 5- and 10-year grades 3 cumulative late toxicity 2.5% (95% CI 2.0-5.9) and 4% (95% CI 2.0-5.9). CONCLUSION: Brachytherapy managed within the frame of a multidisciplinary approach - from diagnosis to evaluation - may offer optimized results with a reduced late toxicity rate, while remaining opened to dosimetry and technical improvements.