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. 2019 Mar-Apr;45(2):288-298.
doi: 10.1590/S1677-5538.IBJU.2018.0142.

Prostate brachytherapy with iodine-125 seeds: analysis of a single institutional cohort

Elton Trigo Teixeira Leite  1   2 , João Luis Fernandes da Silva  1 , Eduardo Capelletti  1 , Cecilia Maria Kalil Haddad  1 , Gustavo Nader Marta  1   2
Affiliations

Prostate brachytherapy with iodine-125 seeds: analysis of a single institutional cohort

Elton Trigo Teixeira Leite et al. Int Braz J Urol. 2019 Mar-Apr.

Abstract

Objectives: Brachytherapy (BT) with iodine-125 seeds placement is a consolidated treatment for prostate cancer. The objective of this study was to assess the clinical outcomes in patients with prostate cancer who underwent low-dose-rate (LDR) -BT alone in a single Brazilian institution.

Materials and methods: Patients treated with iodine-125 BT were retrospectively assessed after at least 5 years of follow-up. Patients who received combination therapy (External beam radiation therapy-EBRT and BT) and salvage BT were not included.

Results: 406 men were included in the study (65.5% low-risk, 30% intermediate-risk, and 4.5% high-risk patients). After a median follow-up of 87.5 months, 61 (15.0%) patients developed biochemical recurrence. The actuarial biochemical failure-free survival (BFFS) at 5 and 10 years were 90.6% and 82.2%, respectively. A PSA nadir ≥ 1 ng / mL was associated with a higher risk of biochemical failure (HR = 5.81; 95% CI: 3.39 to 9.94; p ≤ 0.001). The actuarial metastasis-free survival (MFS) at 5 and 10 years were 98.3% and 94%, respectively. The actuarial overall survival (OS) at 5 and 10 years were 96.2% and 85.1%, respectively. Acute and late grade 2 and 3 gastrointestinal toxicities were observed in 5.6%, 0.5%, 4.6% and 0.5% of cases, respectively. For genitourinary the observed acute and late grade 2 and 3 toxicities rates were 57.3%, 3.6%, 28% and 3.1%, respectively. No grade 4 and 5 were observed.

Conclusions: BT was effective as a definitive treatment modality for prostate cancer, and its endpoints and toxicities were comparable to those of the main series in the literature.

Keywords: Brachytherapy; Iodine-125 [Supplementary Concept]; Prostate.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1. Estimates of biochemical failure-free survival in prostate cancer patients undergoing brachytherapy, obtained using the Kaplan-Meier method.
Figure 2
Figure 2. Estimates of biochemical failure-free survival in prostate cancer patients undergoing brachytherapy, obtained using the Kaplan-Meier method and according to the risk group.
Figure 3A
Figure 3A. Estimates of biochemical failure-free survival in prostate cancer patients undergoing brachytherapy, obtained using the Kaplan-Meier method and according to the PSA nadir.
Figure 3B
Figure 3B. Estimates of biochemical failure-free survival in prostate cancer patients undergoing brachytherapy, obtained using the Kaplan-Meier method and according to the first PSA.
Figure 4
Figure 4. Estimates of overall survival in prostate cancer patients undergoing brachytherapy, obtained using the Kaplan-Meier method.
See this image and copyright information in PMC

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