Pathology and Quality of Life Outcomes Following Office-based Transperineal Prostate Biopsy.

Objective: To report the incidence of prostate cancer diagnosis and quality of life outcomes following transperineal prostate biopsy.

Methods: Forty-six consecutive patients underwent office-based transperineal prostate biopsy for an elevated prostate-specific antigen and a normal digital rectal examination without prior prostate biopsy. Prior to biopsy, a repeat prostate-specific antigen was obtained to ensure persistent elevation.

Is supplemental external beam radiation therapy essential to maximize brachytherapy outcomes in patients with unfavorable intermediate-risk disease?

Purpose: To evaluate whether supplemental external beam radiotherapy (EBRT) is essential to maximize Pd-103 brachytherapy outcomes in patients with unfavorable intermediate-risk (IR) disease.

Methods And Materials: A total of 630 patients were assessed from two prospective randomized brachytherapy trials evaluating the role of supplemental EBRT in patients with higher risk features. Patients were stratified into unfavorable IR (primary Gleason pattern 4, ≥50% positive biopsies, or ≥2 IR features), favorable IR, and high-risk (HR) cohorts.

Treatment outcomes with permanent brachytherapy in high-risk prostate cancer patients stratified into prognostic categories.

Purpose: To determine whether a previously reported substratification system can be extrapolated to patients with high-risk prostate cancer treated with permanent interstitial brachytherapy.

Methods And Materials: Four hundred six National Comprehensive Cancer Network patients with high-risk prostate cancer treated with permanent prostate brachytherapy with or without supplemental external beam radiotherapy were stratified into good (prostate-specific antigen >20 or Gleason score ≥8 or ≥T3), intermediate (prostate-specific antigen >20 and ≥T3), and poor (Gleason score ≥8 with ≥1 additional high-risk feature) prognostic cohorts. Because of only 1 patient with intermediate high-risk disease, the analysis was performed on patients in the good and poor cohorts.

Is supplemental external beam radiation therapy necessary for patients with higher risk prostate cancer treated with 103Pd? Results of two prospective randomized trials.

Purpose: To determine the necessity and/or dose of supplemental external beam radiotherapy (EBRT) in conjunction with palladium-103 ((103)Pd) brachytherapy for high-risk prostate cancer patients.

Methods And Materials: Trial 44/20 randomized patients to 44 Gy plus 90 Gy (103)Pd vs. 20 Gy with 115 Gy (103)Pd, and the subsequent trial randomized patients to the 20 Gy arm vs.

Multisector prostate dosimetric quality: analysis of a large community database.

Purpose: To evaluate multi-institutional prostate brachytherapy dosimetric quality using multisector analysis.

Methods And Materials: In the database, 4547 patients underwent brachytherapy (3094 for (125)I, 1437 for (103)Pd, and 16 for (131)Cs). The original prostate postimplant dosimetry was reported using the maximum dose covering 90% of the prostate volume (D90) and the percentage of the prostate volume covered by the prescription dose (V100).