Clinical outcomes of 125I brachytherapy with and without external-beam radiation therapy for localized prostate cancer: results from 300 patients at a single institution in Japan

J Radiat Res. 2017 Nov 1;58(6):870-880. doi: 10.1093/jrr/rrx051.

Abstract

The aim of this study was to determine the outcomes and adverse events for 300 men with prostate cancer treated with 125iodine (125I) brachytherapy with and without external-beam radiation therapy (EBRT) at a single institution in Japan. Between February 2005 and November 2011, 300 consecutive patients with clinically localized prostate cancer were treated with 125I brachytherapy at the Nagoya University Hospital. A total of 271 men were treated with implants with doses of 145 Gy, and 29 men were treated with implants with doses of 110 Gy combined with EBRT (40-50 Gy/20-25 fractions). The median patient age was 69 years (range, 53-83 years). The median follow-up period was 53 months (range, 5-99 months). According to the National Comprehensive Cancer Network risk classification, 132 men (44%) had low-risk, 147 men (29%) had intermediate-risk and 21 men (7%) had high-risk disease. The 5-year overall survival rate, biochemical relapse-free survival rate, and disease-specific survival rates were 93.5%, 97.3% and 98.5%, respectively. Two men (0.6%) died of prostate cancer and 10 men (3.3%) died of other causes. Seventeen men (5.6%) experienced Grade 2 rectal bleeding in all: 12 (41.4%) of 29 in brachytherapy with EBRT, and 5 (1.8%) of 271 in brachytherapy alone. The rates of Grade 2 and 3 genitourinary toxicity were 1.0% and 1.7%, respectively. Excellent local control was achieved at our hospital for localized prostate cancer with 125I brachytherapy with and without EBRT. Gastrointestinal and genitourinary toxicities were acceptable.

Keywords: brachytherapy; external-beam radiation therapy; gastrointestinal toxicity; genitourinary toxicity; outcome; prostate cancer.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brachytherapy*
  • Disease-Free Survival
  • Humans
  • Iodine Radioisotopes / chemistry*
  • Japan
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prostatic Neoplasms / radiotherapy*
  • Radiotherapy Dosage
  • Risk Factors
  • Survival Analysis
  • Treatment Outcome

Substances

  • Iodine Radioisotopes
  • Iodine-125