Aims And Background: To evaluate long-term outcome and biochemical progression-free survival (bPFS) in high-risk prostate cancer patients treated with brachytherapy combined with external-beam radiation therapy (EBRT) and androgen deprivation therapy (ADT).
Methods And Study Design: We retrospectively analyzed 97 high-risk prostate cancer patients treated with brachytherapy combined with EBRT and ADT. During follow-up, the post-operation prostate-specific antigen (PSA) level was monitored regularly and biochemical relapse, progression to castration-resistant prostate cancer or metastases, and causes of death were documented. We evaluated bPFS, cause-specific survival (CSS) and overall survival (OS).
Results: The bPFS, CSS and OS of the patients were 81.4%, 88.7% and 81.4%, respectively. The bPFS of the subcategories of patients stratified based on the presence or absence of a Gleason pattern 5 were 55.6% and 87.7%, respectively.
Conclusion: Brachytherapy combined with EBRT and ADT can effectively control PSA level and delay biochemical relapse in localized high-risk prostate cancer. However, patients presenting with a Gleason pattern 5 should be managed with further treatment intensification.
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