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Combination radiation therapy beneficial in intermediate- and high-risk prostate cancer

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2011 ASTRO Annual Meeting

MIAMI - Combination low-dose rate brachytherapy and external beam radiation treatment yielded excellent outcomes in patients with intermediate- and high-risk prostate cancer.

Eyud Abu-Isa, MD, and colleagues from the University of Michigan Medical Center evaluated the outcomes of the combination treatment in 159 intermediate-risk patients and 118 high-risk patients who were treated from 1995 to 2008. The median follow-up was 3.4 years for biochemical control and 5.5 years for survival.

The median planned implant dose was 90 Gy and the median external beam radiation treatment pelvic dose was 45 Gy. Androgen deprivation therapy was used in 36% of the intermediate-risk patients for a median of 4 months, and 88% of the high-risk patients for a median of 12 months. Patient-reported outcomes of genitourinary symptoms, gastrointestinal symptoms and sexual function were measured in 85% of patients at baseline and follow-up. The researchers analyzed freedom from biochemical failure, freedom from metastasis and cause-specific survival.

Patients with intermediate-risk disease had a 94% rate of freedom from biochemical failure, 98% rate of freedom from metastasis and a 100% rate of survival. Patients with high-risk disease had a 75% rate of freedom from biochemical failure, an 87% rate of freedom from metastasis and a 90% rate of survival. In high-risk patients with a PSA <20, the freedom from biochemical failure rate was 88%, the freedom from metastasis rate was 91% and the survival rate was 95%.

After a 4-year follow-up, the mean AUA score was 5.8, the mean rate of dysuria episodes was 0.57 and the mean rectal distress score was 0.35. In men who had no or minimal erectile dysfunction at baseline, the potency preservation was 58% in those without prior ADT and 57% in those with prior ADT.

For more information:

• Abu-Isa EI. #2396. Presented at: the 2011 ASTRO Annual Meeting; Oct. 2-6, 2011; Miami.

Disclosure: The researchers report no relevant financial disclosures.

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