The purpose of this study was to evaluate the incidence of late severe (≥Grade 3) urinary toxicity and the long-term efficacy after low-dose-rate brachytherapy (LDR-BT) in patients with localized prostate cancer (PCa).
During the years 1999-2008, 241 patients with PCa who underwent LDR-BT with I125 and were followed up in Kuopio University Hospital were included to this analysis. The incidence of late severe (Grade 3) urinary toxicity and the long-term efficacy results were analyzed.
All D’Amico risk groups were represented, as 58.9%, 35.3%, and 5.8% of the patients were classified as low-, intermediate-, and high-risk patients, respectively. With a median followup of 11.4 years after implantation, the incidence of severe urinary toxicity increased throughout the followup period. The risk of Grade 3 urinary toxicity was highest among patients with higher Gleason scores (p = 0.016) and higher initial urine residual volumes (p = 0.017) and the cumulative incidence of severe urinary toxicity was 10.0%. The crude rate for transurethral prostatic resection was 5.8%. The relapse-free survival, the cause-specific survival, and the overall survival were 79.3%, 95.0%, and 66.4%, respectively.
The treatment was well tolerated as 90% of patients avoided any Grade 3 urinary toxicity. LDR-BT for localized PCa achieved high and durable efficacy. These results support the role of LDR-BT monotherapy as one of the valid primary treatment options for low-risk and favorable intermediate-risk patients.
Brachytherapy. 2019 Jun 18 [Epub ahead of print]
Kristiina Vuolukka, Päivi Auvinen, Jan-Erik Palmgren, Tuuli Voutilainen, Sirpa Aaltomaa, Vesa Kataja
Department of Oncology, Cancer Center, Kuopio University Hospital, Kuopio, Finland. Electronic address: ., Department of Oncology, Cancer Center, Kuopio University Hospital, Kuopio, Finland; University of Eastern Finland, Kuopio, Finland., Department of Oncology, Cancer Center, Kuopio University Hospital, Kuopio, Finland., University of Eastern Finland, Kuopio, Finland., Department of Urology, Kuopio University Hospital, Kuopio, Finland., University of Eastern Finland, Kuopio, Finland; Central Finland Central Hospital, Jyväskylä, Finland.