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Prostate Brachytherapy With Cs-131: Long-term Results Compared With Published Stereotactic Body Radiotherapy Data.

Ryan P Smith1, Mohammed A Mohammed1, Sushil Beriwal2

  • 1Department of Radiation Oncology, UPMC Hillman Cancer Center.

American Journal of Clinical Oncology
|December 24, 2024
PubMed
Summary
This summary is machine-generated.

Cesium-131 prostate brachytherapy (PB) offers excellent biochemical control for low and intermediate-risk prostate cancer. Patient-reported quality of life outcomes were comparable to stereotactic body radiotherapy, supporting PB consideration.

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Area of Science:

  • Oncology
  • Radiation Therapy
  • Urology

Background:

  • Low-dose rate (LDR) prostate brachytherapy (PB) using Cesium-131 (Cs-131) is a treatment option for prostate cancer.
  • Comparing PB outcomes with other radiotherapy modalities is crucial for treatment selection.

Purpose of the Study:

  • To compare outcomes of Cs-131 PB monotherapy with stereotactic body radiotherapy (SBRT) using published data.
  • To evaluate patient-reported quality of life after Cs-131 PB.

Main Methods:

  • Analysis of 138 patients treated with Cs-131 PB monotherapy with at least 5 years of follow-up.
  • Prospective collection of Expanded Prostate Cancer Index Composite (EPIC) questionnaires.
  • Comparison with data from Radiation Therapy Oncology Group (RTOG) 0938 and PACE-B trials.

Main Results:

  • Urinary function decline was 43% in Cs-131 PB vs. 41.3% in RTOG 0938.
  • At 2 years, Cs-131 PB showed minimal clinically important differences in urinary domains (26.4% incontinence, 40.7% obstructive/irritative) compared to PACE-B (32%, 33%).
  • Five-year biochemical disease-free survival (bDFS) was 97.8% for Cs-131 PB, compared to 91.3% (RTOG 0938) and 95.8% (PACE-B).

Conclusions:

  • Cs-131 PB monotherapy demonstrates excellent biochemical control for low and intermediate-risk prostate cancer.
  • Patient-reported urinary and bowel quality of life changes were modest and comparable to SBRT.
  • Cs-131 PB is a viable treatment option considering patient convenience and resource availability.