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Journal of Oncology
Volume 2010, Article ID 471375, 6 pages
http://dx.doi.org/10.1155/2010/471375
Clinical Study

Long-Term Outcomes for Patients with Prostate Cancer Having Intermediate and High-Risk Disease, Treated with Combination External Beam Irradiation and Brachytherapy

1Dattoli Cancer Center & Brachytherapy Research Institute, 2803 Fruitville Rd., Sarasota, FL 34237-5367, USA
2Department of Radiation Oncology and Pathology, University of Washington, Seattle, WA 98195-0001, USA
3Radiation Oncology, Puget Sound Health Care System, Department of Veterans Affairs, Seattle, WA 98108-1597, USA
4Group Health Cooperative, Seattle, WA 98124-1590, USA
5Research Division, Bostwick Laboratories, Richmond, VA 23050-4410, USA

Received 28 April 2010; Revised 1 July 2010; Accepted 1 July 2010

Academic Editor: Minesh P. Mehta

Copyright © 2010 Michael Dattoli et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Perception remains that brachytherapy-based regimens are inappropriate for patients having increased risk of extracapsular extension (ECE). Methods. 321 consecutive intermediate and high-risk disease patients were treated between 1/92 and 2/97 by one author (M. Dattoli) and stratified by NCCN guidelines. 157 had intermediate-risk; 164 had high-risk disease. All were treated using the combination EBRT/brachytherapy ± hormones. Biochemical failure was defined using PSA > 0 . 2 and nadir +2 at last followup. Nonfailing patients followup was median 10.5 years. Both biochemical data and original biopsy slides were independently rereviewed at an outside institution. Results. Overall actuarial freedom from biochemical progression at 16 years was 82% (89% intermediate, 74% high-risk) with failure predictors: Gleason score ( 𝑃 = . 0 1 ) and PSA ( 𝑃 = . 0 3 ) . Hormonal therapy did not affect failure rates ( 𝑃 = . 1 4 ) . Conclusion. This study helps to strengthen the rationale for brachytherapy-based regimens as being both durable and desirable treatment options for such patients. Prospective studies are justified to confirm these positive results.