Outcomes following iodine-125 brachytherapy in patients with Gleason 7, intermediate risk prostate cancer: A population-based cohort study

Published:February 13, 2012DOI:https://doi.org/10.1016/j.radonc.2012.01.006

      Abstract

      Background and purpose

      To evaluate outcome in patients with Gleason 7 prostate cancer treated with iodine-125 brachytherapy at the British Columbia Cancer Agency.

      Materials and methods

      Between 20th July 1998 and 7th February 2006, 1500 patients underwent I-125 prostate brachytherapy without supplemental external beam radiation therapy. Of these, 439 had Gleason 7 disease; 362 had Gleason 3 + 4 and 77 had 4 + 3 disease. Generally, patients received 6 months of androgen suppression. We compared biochemical no evidence of disease (bNED) between patients with Gleason ⩽6 and Gleason 7 and between Gleason 3 + 4 and 4 + 3 using the Phoenix definition of biochemical recurrence.

      Results

      Median follow-up was 60 months. Estimated 5 year bNED was 97% for patients with Gleason score ⩽6 and 94% for patients with Gleason 7 disease (p = 0.037). Estimated bNED was 95% and 94% for 3 + 4 and 4 + 3, respectively (p = 0.791). There was no difference in bNED between implants achieving D90 ⩾ versus < the median value (150.5 Gy) or ⩾ versus < 140 Gy.

      Conclusions

      I-125 brachytherapy with 6 months of ADT demonstrates excellent bNED rates in Gleason 7 disease. We found no evidence of a difference between patients with Gleason 3 + 4 versus 4 + 3 disease.

      Keywords

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