High dose-rate brachytherapy boost for intermediate risk prostate cancer: Long-term outcomes of two different treatment schedules and early biochemical predictors of success

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
Joelle HelouGerard Morton

Abstract

To report long-term cancer control rates following high dose-rate (HDR) brachytherapy boost for intermediate risk prostate cancer and explore early biochemical predictors of success. Results of two sequential phase II trials are updated and compared: (1) Single 15 Gy HDR-boost followed by external beam radiotherapy (EBRT) 37.5 Gy/15fractions, (2) Two HDR fractions of 10 Gy followed by EBRT 45 Gy/25fractions. Patients were followed prospectively for clinical and biochemical outcomes. Nadir PSA (nPSA) and PSA at 3-years were analyzed as continuous variables, and ROC analysis was used to identify the optimal cutoff values. Kaplan-Meier bDFS curves were generated and the log-rank test used to compare different groups 183 patients were accrued; 123 to the single fraction trial and 60 to the standard fractionation trial, with a median follow-up of 74 months and 99 months, respectively. The 5-year biochemical relapse-free survival was 97.4% and 92.7%, respectively (p=0.995). Median nPSA was 0.08 ng/ml. Failure to achieve a nPSA <0.4 ng/ml was associated with a significantly higher rate of biochemical relapse (5-year bDFS: 100% vs. 72%; p<0.0001). HDR boost with single fraction 15 Gy provides durable long-term biochemical disease-free ...Continue Reading

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Citations

Jan 27, 2016·Cancer radiothérapie : journal de la Société française de radiothérapie oncologique·N Thiruthaneeswaran, P J Hoskin
Jul 7, 2015·Acta Oncologica·Peter J Hoskin
Oct 26, 2016·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Eric VigneaultLuc Beaulieu
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Jul 18, 2020·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Carl SalembierDirk Van Gestel

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