External-Beam Radiation Therapy and High–Dose Rate Brachytherapy Combined With Long-Term Androgen Deprivation Therapy in High and Very High Prostate Cancer: Preliminary Data on Clinical Outcome

Martı́nez-Monge, Rafael; Moreno, Marta; Ciérvide, R.; Cambeiro, Mauricio; Pérez-Gracia, José Luis; Gil-Bazo, Ignacio; Gaztañaga, Miren; Arbea, Leire; Pascual, Ignacio; Aristu, Javier

doi:10.1016/j.ijrobp.2011.08.002

Cited by 41 publications

(18 citation statements)

References 29 publications

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“…Toxicity in the present study is minimal when compared with the previous reports using LDR [3, 11] and HDR [12, 13, 14] in combination with EBRT. Although the total number of N1 disease patients in the present study was limited, the good biochemical control obtained using LDR in combination with whole pelvis EBRT is encouraging.…”

Section: Discussioncontrasting

confidence: 54%

“…Similarly, high-dose-rate (HDR) brachytherapy is a modality that can deliver high BED in combination with EBRT. A previous study using HDR-based radiotherapy in combination with EBRT and long-term ADT, demonstrated a favorable 5 year BFFS of 85.1% with a median follow-up of 44 months for high-risk and very high-risk prostate cancer patients, including some in the intermediate risk category [12]. The data showed that biochemical failure occurred at a median of 40 months [12].…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

High biologically effective dose radiation therapy using brachytherapy in combination with external beam radiotherapy for high-risk prostate cancer

Okamoto¹,

Wada²,

Kohno

2017

jcb

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PurposeTo evaluate the outcomes of high-risk prostate cancer patients treated with biologically effective dose (BED) ≥ 220 Gy of high-dose radiotherapy, using low-dose-rate (LDR) brachytherapy in combination with external beam radiotherapy (EBRT) and short-term androgen deprivation therapy (ADT).Material and methodsFrom 2005 to 2013, a total of 143 patients with high-risk prostate cancer were treated by radiotherapy of BED ≥ 220 Gy with a combination of LDR brachytherapy, EBRT, and androgen deprivation therapy (ADT). The high-risk patients in the present study included both high-risk and very high-risk prostate cancer. The number of high-risk features were: 60 patients with 1 high-risk factor (42%), 61 patients with 2 high-risk factors (43%), and 22 patients with 3 high-risk factors (15%) including five N1 disease. External beam radiotherapy fields included prostate and seminal vesicles only or whole pelvis depending on the extension of the disease. Biochemical failure was defined by the Phoenix definition.ResultsSix patients developed biochemical failure, thus providing a 5-year actual biochemical failure-free survival (BFFS) rate of 95.2%. Biochemical failure was observed exclusively in cases with distant metastasis in the present study. All six patients with biochemical relapse had clinical failure due to bone metastasis, thus yielding a 5-year freedom from clinical failure (FFCF) rate of 93.0%. None of the cases with N1 disease experienced biochemical failure. We observed four deaths, including one death from prostate cancer, therefore yielding a cause-specific survival (CSS) rate of 97.2%, and an overall survival (OS) rate of 95.5%.ConclusionsHigh-dose (BED ≥ 220 Gy) radiotherapy by LDR in combination with EBRT has shown an excellent outcome on BFFS in high-risk and very high-risk cancer, although causal relationship between BED and BFFS remain to be explained further.

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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 98%

High biologically effective dose radiation therapy using brachytherapy in combination with external beam radiotherapy for high-risk prostate cancer

Okamoto¹,

Wada²,

Kohno

2017

jcb

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“…It is hoped that collecting outcomes based on these parameters betters the understanding of normal tissue tolerances and side effects. 613 The consensus statement further recommended that although HDR monotherapy is more established in its role in the treatment of low and intermediate risk prostate cancer, HDR monotherapy for high-risk prostate cancer should still be considered investigational. 622 High-Dose Rate Brachytherapy.…”

Section: Brachytherapy and Androgen Ablative Therapymentioning

confidence: 99%

Prostate Cancer

Michalski¹,

Pisansky²,

Lawton³

et al. 2016

Clinical Radiation Oncology

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“…The outcome of trimodality treatment is excellent, with 9-year progression-free survival and disease-specific survival rates reaching 87% and 91%, respectively. 17,18 However, whether the ADT component contributes to outcome improvement is unclear. D'Amico et al 19 studied a cohort of 1342 patients with a PSA greater than 20 ng/mL and clinical T3/T4 and/or Gleason score 8 to 10 disease.…”

Section: Pros-9mentioning

confidence: 99%