Assessment of permanent brachytherapy combined with androgen deprivation therapy in an intermediate‐risk prostate cancer group without a Gleason score of 4 + 3: A single Japanese institutional experience. (22nd August 2013)

• Record Type: Journal Article
• Authors: Okihara, Koji; Kobayashi, Kana; Iwata, Tsuyoshi; Naitoh, Yasuyuki; Kamoi, Kazumi; Kawauchi, Akihiro; Yamada, Kei; Miki, Tsuneharu
• Is Part Of: International journal of urology. Volume 21:Number 3(2014)
• Page Start: 271
• Page End: 276
• Publication Date: 2013-08-22
• Subjects: Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/iju.12245
• Languages: English
• ISSNs: 0919-8172

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="iju12245-sec-0001" sec-type="section"> <title>Objectives</title> <p>To evaluate the outcome of low‐dose‐rate permanent brachytherapy combined with anti‐androgen deprivation therapy for intermediate‐risk prostate cancer excluding biopsy Gleason score 4 + 3.</p> </sec> <sec id="iju12245-sec-0002" sec-type="section"> <title>Methods</title> <p>Patients included in the intermediate‐risk group were those presenting clinical stage T1c to T2c (by magnetic resonance imaging staging), Gleason score 3 + 4 or lower and/or prostate‐specific antigen less than 20 ng/mL, whereas those with clinical stage T1c to T2a, Gleason score 3 + 3 and prostate‐specific antigen less than 10 ng/mL represented the low‐risk group, and were used as controls. In the intermediate‐risk group, therapy with a luteinizing hormone‐releasing hormone analog was continued for at least 6 months before and after permanent brachytherapy.</p> </sec> <sec id="iju12245-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 147 low‐risk group patients and 139 intermediate‐risk group patients were included in the study. The median follow up was 51 and 52 months for the intermediate‐risk group and low‐risk group, respectively. The 5‐year overall, cause‐specific and distant‐metastasis‐free survival rates in the low‐risk group and intermediate‐risk group were 97.6/99.2, 100/100 and 100/100%, respectively. The 5‐year biochemical disease‐free survival in these groups were 95.9 and 92.5%, respectively (<italic>P</italic> = 0.18). There was no sexual activity and desire for erection before treatment in 50%, and in 46% of the patients in the low‐risk group and intermediate‐risk group, respectively. Overall satisfaction score at 2 years after permanent brachytherapy significantly improved, compared with pretreatment (<italic>P</italic> = 0.0399).</p> </sec> <sec id="iju12245-sec-0004" sec-type="section"> <title>Conclusions</title> <p>In intermediate‐risk prostate cancer, excluding biopsy Gleason score 4 + 3, permanent brachytherapy combined with androgen deprivation therapy for 6 months or more represents an effective treatment option in Japanese patients, based on a favorable prognosis, adverse event profile and quality of life analysis.</p> </sec> </abstract>