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Published on: February 6, 2019
Patterns of local failure following prostate brachytherapy
Nelson N Stone1, Richard G Stock, Ida White
1Department of Urology, Mount Sinai School of Medicine, New York, NY, USA. nelsonstone@optonline.net
The Journal of Urology
|April 18, 2007
Summary
Adequate radiation dose and hormonal therapy are crucial for prostate brachytherapy success. Positive biopsies after treatment indicate higher prostate cancer recurrence and mortality risks.
Area of Science:
- Urology
- Radiation Oncology
- Oncology
Background:
- Prostate brachytherapy is a common treatment for localized prostate cancer.
- Biopsy results after treatment are important indicators of disease control.
Purpose of the Study:
- To analyze biopsy results in patients treated with permanent prostate brachytherapy.
- To identify factors associated with positive biopsy outcomes and their impact on survival.
Main Methods:
- 1,562 men with localized prostate cancer underwent permanent prostate brachytherapy.
- 508 men had ultrasound-guided biopsies 2 years post-treatment.
- Survival analysis used Kaplan-Meier and Cox regression.
Main Results:
- 7.7% of men had a positive final biopsy.
- Positive biopsies correlated with higher PSA, advanced stage, higher risk disease, no hormonal therapy, and lower radiation dose.
- Positive biopsy was a significant predictor of prostate cancer death (OR 18.5).
Conclusions:
- Sufficient radiation dose is essential for local disease eradication in prostate brachytherapy.
- Hormonal therapy may improve local control for intermediate to high-risk patients.
- Extraprostatic biopsies are recommended for patients with local failure to assess seminal vesicle involvement.
