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A simple model predicts freedom from biochemical recurrence after low-dose rate prostate brachytherapy alone.

Papagikos MA, Rossi PJ, Urbanic JJ, deGuzman AF, McCullough DL, Clark PE, Lee WR
Am J Clin Oncol. 2007 30 (2): 199-204

PMID: 17414471 · DOI:10.1097/01.coc.0000251402.85009.af

OBJECTIVE - The objective of this study was to describe a simple model that predicts freedom from biochemical recurrence (FFBR) in men with prostate cancer after treatment with low-dose rate prostate brachytherapy (LDRPB) alone.

MATERIALS AND METHODS - One hundred thirty-two men were treated with LDRPB alone between September 1997 and April 2001. Sixty-four percent of men had low-risk disease (prostate-specific antigen [PSA] <10, Gleason <7, and T stage or =10, Gleason > or =7, or T stage T2b). The dosimetric quantifier D90 was calculated from a computed tomography scan performed 1 month after LDRPB. The percent positive biopsies (PPB) were determined for all patients. FFBR was estimated using the product limit method. All P values are 2-sided.

RESULTS - The median follow-up is 65 months. The median D90 is 138 Gy (range, 47-221 Gy). Fourteen men have developed evidence of biochemical relapse at a median of 27 months (range, 6-42 months). The 5-year FFBR rate for the entire cohort is 88%. On univariate analysis, variables found to be associated with FFBR included: PSA, Gleason score, T stage, risk group, PPB, and D90. Multivariate analysis indicated that D90, PPB, and risk group were independently associated with FFBR. Patients were categorized based on the following 3 adverse prognostic factors: D90 <140 Gy, PPB > or =50%, and intermediate-risk group. Group 1 (0 factors, n = 30), group 2 (1 factor, n = 72), and group 3 (> or =2 factors, n = 30) patients had 5-year FFBR rates of 100% (+/-0%), 92% (+/-6%), and 67% (+/-18%) (P < 0.0001).

CONCLUSIONS - We have developed a simple, robust model based on implant quality and disease factors that predicts FFBR in men with prostate cancer treated with LDRPB alone.

MeSH Terms (18)

Aged Aged, 80 and over Analysis of Variance Biopsy Brachytherapy Cohort Studies Follow-Up Studies Humans Male Middle Aged Models, Statistical Multivariate Analysis Neoplasm Staging Predictive Value of Tests Prostate-Specific Antigen Prostatic Neoplasms Radiotherapy Dosage Recurrence

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