AI Article Synopsis
- The study retrospectively evaluated the effectiveness of ultra-low dose rate brachytherapy (uLDR-BT) in 39 patients with unfavorable intermediate risk prostate cancer, despite current guidelines recommending against it due to insufficient evidence.
- Results showed a promising median follow-up of about 56 months, with an 87.02% biochemical failure-free survival rate, indicating uLDR-BT could be a viable treatment option.
- No significant differences in outcomes were observed based on additional risk factors or treatment methods, suggesting that uLDR-BT's effectiveness is consistent across different patient profiles in the intermediate risk category.
Article Abstract
Background: Treatment with sole ultra-low dose rate brachytherapy (uLDR-BT) for unfavorable intermediate risk factor (IUR) group prostate cancer patients is not recommended by guidelines due to the lack of strong evidence of its effectiveness. However, there were numerous patients treated with good results with this method in older trials. Purpose of this work was to retrospectively asses effectiveness of uLDR-BT in IUR group treated in our department.
Materials And Methods: We performed retrospective analysis of 39 IUR prostate cancer patients treated in our department with uLDR-BT between 2015-2019. All Patients had confirmed prostate cancer in biopsy and had local staging assessed with digital rectal examination and either transrectal ultrasound (TRUS) or magnetic resonance imaging (MRI) before treatment. Treatment was performed using I seeds, and the dose prescribed to the clinical target volume was 145 Gy. After treatment, all patients were followed in our outpatient ambulatory one month after the procedure and every 3-6 months later on. Toxicity was assessed using the International Prostate Symptom Score (IPSS) and Radiation Therapy Oncology Group (RTOG) scales.
Results: The median follow-up was 56,3 months [interquartile range (IQR): 36.9-73.4]. The mean nadir prostate-specific antigen (PSA) was 0.20 ng/mL (range 0.001-1.7). The actuarial 5-year biochemical failure-free survival (BFFS) was 87.02%. There was no statistically significant difference in BFFS between groups with antigen deprivation therapy (ADT) and without (p = 0.439). Analysis also showed no impact on BFFS of each intermediate group risk factors: initial PSA (iPSA) (p = 0.595). Gleason (p = 0.671) and Tumor stage (p = 0.694). There were no statistically significant differences in BFFS depending on number of those factors (p = 0.330).
Conclusion: The uLDR-BT may be an effective option for selected IUR prostate cancer patients.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11698563 | PMC |
| http://dx.doi.org/10.5603/rpor.103135 | DOI Listing |
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