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Risk group stratification in patients undergoing permanent (125)I prostate brachytherapy as monotherapy.

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  • 1Department of Radiation Oncology, School of Medicine, University of Maryland Medical Center, 22 S. Greene Street, Baltimore, MD 21201, USA

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Summary

Prostate brachytherapy (PB) monotherapy shows varying success based on risk. Favorable risk patients achieve good outcomes, but unfavorable risk prostate cancer patients require additional therapies for effective treatment.

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Urology

Background:

  • Prostate brachytherapy (PB) is often used as monotherapy for favorable-risk prostate cancer.
  • Intermediate and high-risk patients may receive PB monotherapy without external beam radiotherapy (EBRT) or hormonal therapy.

Purpose of the Study:

  • To report the outcomes of prostate cancer patients treated with PB monotherapy.
  • To stratify outcomes based on favorable, intermediate, and unfavorable risk groups with extended follow-up.

Main Methods:

  • 102 patients with localized prostate cancer underwent PB monotherapy.
  • Patients were stratified into favorable, intermediate, and unfavorable risk groups.
  • Prostate-specific antigen (PSA) relapse-free survival (PRFS) was the primary endpoint, with a median follow-up of 7 years.

Main Results:

  • The 5-year PRFS rates were 85% for favorable, 63% for intermediate, and 24% for unfavorable risk groups (p <0.0001).
  • Biochemical relapse occurred in 40 patients, predominantly within the first 5 years.
  • Higher pretreatment PSA (>10 ng/mL) and Gleason score (≥7) significantly correlated with lower PRFS rates.

Conclusions:

  • PB monotherapy demonstrates comparable PRFS to EBRT and surgery at 7 years for select patients.
  • PB monotherapy is significantly less effective in patients with unfavorable risk factors.
  • Additional therapeutic interventions are recommended for unfavorable-risk prostate cancer patients undergoing PB.