Long term outcome and side effects in patients receiving low-dose I125 brachytherapy: a retrospective analysis

Abstract

Objectives:To retrospectively evaluate the disease free survival (DFS), disease specific survival (DSS),overall survival (OS) and side effects in patients who received low-dose rate (LDR) brachytherapy with I125 stranded seeds.Materials and methods:Between july 2003 and august 2012, 274 patients with organ confined prostate cancer were treated with permanent I125 brachytherapy. The median follow-up, age and pretreatment prostate specific antigen (iPSA) was 84 months (12-120), 67 years (50-83) and 7.8 ng/mL (1.14-38), respectively. Median Gleason score was 6 (3-9). 219 patients (80%) had stage cT1c, 42 patients (15.3%) had stage cT2a, 3 (1.1%) had stage cT2b and 3 (1.1%) had stage cT2c. The median D90 was 154.3 Gy (102.7-190.2).Results:DSS was 98.5%.OS was 93.5%. 13 patients (4.7%) developed systemic disease, 7 patients (2.55%) had local progression. In 139 low risk patients, the 5 year biochemical freedom from failure rate (BFFF) was 85% and 9 patients (6.4%) developed clinical progression. In the intermediate risk group, the 5 year BFFF rate was 70% and 5 patients (7.1%) developed clinical progression. Median nPSA in patients with biochemical relapse was 1.58 ng/mL (0.21 – 10.46), median nPSA in patients in remission was 0.51 ng/mL (0.01 – 8.5). Patients attaining a low PSA nadir had a significant higher BFFF (p<0.05). Median D90 in patients with biochemical relapse was 87.2 Gy (51 – 143,1). Patients receiving a high D90 had a significant higher BFFF (p<0.05).Conclusion:In a well selected patient population, LDR brachytherapy offers excellent outcomes. Reaching a low PSA nadir and attaining high D90 values are significant predictors for a higher DFS.

A single institution analysis of low-dose-rate brachytherapy: 5-year reported survival and late toxicity outcomes

“…In the study by Logghe et al . [ 17 ], 274 patients with organ-confined prostate cancer were treated with LDR brachytherapy. Follow-up 5-year data revealed disease-specific survival and overall survival to be 98.5% and 93.5%.…”

A Case of Iodine 125 Seeds (I-125) Responding to Lung Squamous Cell Carcinoma

“…17 Low-dose rate brachytherapy showed excellent outcomes in a well selected patient population. 18 Therefore, I-125 seeds work incredibly well and have high security for the patients with large tumor. In this patient, following treatment with I-125 seeds, and combined with chemotherapy, the lesion in lung rapidly shrinked without discomfort or pain sensation.…”

Comparison of the medical costs between active surveillance and other treatments for early prostate cancer in Japan using data from the PRIAS‐JAPAN study

“…Although approximately 20% of the patients who receive RALP experience incontinence, 24 it is unknown whether they require treatment (medications, pelvic muscle exercises, and artificial urinary sphincters). Similarly, because the toxicity of radiotherapy was reported based on the grade of the genitourinary and gastrointestinal toxicity in previous studies, 25,26 side effects (such as dysuria, urinary frequency, hematuria, rectal bleeding, and prostatitis) were unknown. Therefore, it was difficult to estimate the costs of surgery-and radiotherapy-related complications.…”