[Long-term outcomes of 125I brachytherapy combined with maximal androgen blockade for metastatic prostate cancer].

Objective: To investigate the long-term clinical value of prostate 125I brachytherapy (BT) combined with maximal androgen blockade (MAB) in the treatment of metastatic prostate cancer (mPCa).

Methods: We retrospectively analyzed the clinical data on 173 cases of mPCa treated by MAB (n = 126) or BT+MAB (n = 47) from December 2011 to December 2016 and followed up for 6－76 (44.17 ± 19.73) months. We compared the PSA level, prostate volume, IPSS, progression-free survival, and the rates of 3- and 5-year overall survival between the two groups.

Results: After treatment, the minimum PSA level was significantly lower in the BT+MAB than in the MAB group ［3.77 ± 4.14］ vs ［5.96 ± 7.01］ ng/ml, P = 0.046) and the time to reach the minimum level was shorter in the former than in the latter (［5.19 ± 2.83］ vs ［6.52 ± 3.34］ mo, P = 0.016). The prostate volume was markedly reduced in both of the groups at 1, 3 and 5 years after treatment as compared with the baseline, even more significantly in the BT+MAB than in the MAB group (P < 0.01), though with no statistically significant difference between the two groups before treatment (P = 0.307). The IPSS was remarkably decreased in both of the groups at 1 and 3 years (P < 0.01) but showed no significant difference at 5 years after treatment as compared with the baseline (P > 0.05) or between the two groups before and after treatment (P > 0.05). The progression-free survival was obviously longer in the BT+MAB than in the MAB group (［37.29 ± 15.73］ vs ［29.41 ± 14.37］ mo, P = 0.011), and the rates of 3- and 5-year overall survival were higher in the former than in the latter (74.60% and 60.70% vs 62.60% and 51.50%, P = 0.227 and P = 0.356). Kaplan-Meier survival curves showed no statistically significant difference in the overall survival between the two groups (P = 0.105).

Conclusions: Both MAB and BT+MAB are effective therapies for mPCa, but the latter can achieve a longer progression-free survival.