Brachytherapy + EBRT for High-Risk PCa Offers 'Excellent' Outcomes

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Biochemical failure and prostate cancer-specific mortality rates were 13.3% and 4.9% at 10 years, respectively.
Biochemical failure and prostate cancer-specific mortality rates were 13.3% and 4.9% at 10 years, respectively.

Permanent brachytherapy and supplemental external beam radiation therapy (EBRT) for high-risk prostate cancer (PCa) offers “excellent” long-term biochemical control and cancer-specific survival, according to researchers.

Gregory S. Merrick, MD, of Schiffler Cancer Center, Wheeling Hospital, Wheeling, West Virginia, and colleagues analyzed outcomes of 448 patients with high-risk PCa as defined by National Comprehensive Cancer Network criteria. They stratified patients by pre-treatment PSA level (10 or less, 10.1–20, and greater than 20 ng/mL).

The 10-year overall mortality, biochemical failure, and PCa-specific mortality (PCSM) rates for the entire cohort were 28.5%, 13.3%, and 4.9%, respectively, the investigators reported in the Journal of Contemporary Brachytherapy (2017;9:297-303). The PCSM rates were 2.5%, 10.7%, and 4.5% for patients with pre-treatment PSA levels of 10 or less, 10.1–20, and more than 20 ng/mL, respectively. Dr Merrick's group found no significant difference in biochemical failure or overall survival according to PSA category. Distant failure most commonly occurred in the 10.1–20 ng/mL group.

In multivariate analysis, percent positive biopsies and tobacco use were the strongest predictors of PCSM.

“High-risk prostate cancer treated with permanent prostate brachytherapy and supplement EBRT results in excellent long-term biochemical control and PCSM,” the authors concluded.

Reference

Merrick GS, Galbreath RW, Butler WM, et al. Prostate cancer-specific death in brachytherapy treated high-risk patients stratified by pre-treatment PSA. J Contemp Brachytherapy. 2017;9:297-303. doi:10.5114/jcb.2017.69588

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