Kubicek G.J.,University of Pittsburgh |
Naguib M.,The Radiation Medicine Center |
Redfield S.,The Radiation Medicine Center |
Grayback N.,The Radiation Medicine Center |
Brown S.I.,The Radiation Medicine Center
Brachytherapy | Year: 2011
Purpose: Treatment of prostate cancer using higher doses of external beam radiation (EBRT) has been shown to improve results, but there are toxicity concerns with further dose escalation. A treatment option to safely increase total dose to the prostate includes combination therapy using EBRT and low-dose-rate transperineal brachytherapy seed implant. Our purpose was to report the results of combined modality therapy from a single institution in the community setting. Methods and Materials: Retrospective review from single institution in the community setting. All patients were treated with a combination of EBRT followed by low-dose-rate brachytherapy seed placement. Results: A total of 824 patients were analyzed with a median followup of 5.5 years, all censored patients had a minimum followup of 2 years. A total of 588 patients received hormone therapy before or concurrent with the radiation. Three hundred twenty-nine patients had low-risk disease, 300 patients had intermediate-risk disease, and 195 patients had high-risk disease. Five-year overall survivals were 86.1%, 85.0%, and 82.5% for low-, intermediate-, and high-risk patients. Five-year actuarial biochemical relapse-free survivals (bRFSs) were 85.4%, 83.2%, and 79.6% for low-, intermediate-, and high-risk patients. High-risk patients who received hormonal therapy had an improved bRFS vs. patients not receiving hormones. Conclusions: Combination treatment using brachytherapy and EBRT is well tolerated, with acceptable overall survival and bRFS rates and should be considered a standard treatment option for patients. Hormones should be considered for high-risk patients. © 2011.