Volume 121, Issue 1 p. 38-45
Original Article

Long-term oncological outcomes and toxicity in 597 men aged ≤60 years at time of low-dose-rate brachytherapy for localised prostate cancer

Stephen E. M. Langley

Corresponding Author

Stephen E. M. Langley

St Luke's Cancer Centre, Guildford, Surrey, UK

Correspondence: Stephen E. M. Langley, St. Luke's Cancer Centre, Royal Surrey Hospital, Guildford, Surrey GU2 7XX, UK.

e-mail: [email protected]

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Ricardo Soares

Ricardo Soares

St Luke's Cancer Centre, Guildford, Surrey, UK

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Jennifer Uribe

Jennifer Uribe

St Luke's Cancer Centre, Guildford, Surrey, UK

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Santiago Uribe-Lewis

Santiago Uribe-Lewis

St Luke's Cancer Centre, Guildford, Surrey, UK

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Julian Money-Kyrle

Julian Money-Kyrle

St Luke's Cancer Centre, Guildford, Surrey, UK

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Carla Perna

Carla Perna

St Luke's Cancer Centre, Guildford, Surrey, UK

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Sara Khaksar

Sara Khaksar

St Luke's Cancer Centre, Guildford, Surrey, UK

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Robert Laing

Robert Laing

St Luke's Cancer Centre, Guildford, Surrey, UK

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First published: 03 July 2017
Citations: 22

Abstract

Objectives

To report oncological and functional outcomes of men treated with low-dose-rate (LDR) prostate brachytherapy aged ≤60 years at time of treatment.

Patients and Methods

Of 3262 patients treated with LDR brachytherapy at our centre up to June 2016, we retrospectively identified 597 patients aged ≤60 years at treatment with ≥3-years post-implantation follow-up and four prostate-specific antigen (PSA) measurements, of which one was at baseline. Overall survival (OS), prostate cancer-specific survival (PCSS) and relapse free survival (RFS) were analysed together with prospectively collected physician-reported adverse events and patient-reported symptom scores.

Results

The median (range) age was 57 (44-60) years, follow-up was 8.9 (1.5-17.2) years, and PSA follow-up 5.9 (0.8-15) years. Low-, intermediate- and high-risk disease represented 53%, 37% and 10% of the patients, respectively. At 10 years after implantation OS and PCSS were 98% and 99% for low-risk, 99% and 100% for intermediate-risk, and 93% and 95% for high-risk disease, respectively. At 10 years after implantation RFS, using the PSA level nadir plus 2 ng/mL definition, was 95%, 90% and 87% for low-, intermediate-, and high-risk disease, respectively. Urinary stricture was the most common genitourinary adverse event occurring in 19 patients (3.2%). At 5 years after implantation erectile function was preserved in 75% of the patients who were potent before treatment.

Conclusion

LDR brachytherapy is an effective treatment with long-term control of prostate cancer in men aged ≤60 years at time of treatment. It was associated with low rates of treatment-related toxicity and can be considered a first-line treatment for prostate cancer in this patient group.