• Int. J. Radiat. Oncol. Biol. Phys. · Aug 2010

    Young men have equivalent biochemical outcomes compared with older men after treatment with brachytherapy for prostate cancer.

    • Ryan J Burri, Alice Y Ho, Kevin Forsythe, Jamie A Cesaretti, Nelson N Stone, and Richard G Stock.
    • Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York, USA.
    • Int. J. Radiat. Oncol. Biol. Phys. 2010 Aug 1; 77 (5): 1315-21.

    PurposeTo evaluate retrospectively the biochemical outcomes of young men treated with low-dose-rate brachytherapy for prostate cancer.Methods And MaterialsFrom 1990 to 2005, 1,665 men with clinically localized prostate cancer were treated with low-dose-rate brachytherapy +/- hormone therapy (HT) +/- external beam radiotherapy and underwent > or = 2 years of follow-up. Patients were stratified on the basis of age: < or = 60 (n = 378) and >60 years (n = 1,287). Biochemical failure was defined as a prostate-specific antigen (PSA) nadir plus 2 ng/mL. Univariate and multivariate analyses were used to determine the association of variables with freedom from biochemical failure (FFbF).ResultsMedian follow-up was 68 months (range, 24-180) for men < or = 60 years and 66 months (range, 24-200) for men >60. For the entire group, the actuarial 5- and 8-year FFbF rates were 94% and 88%, respectively. Men < or = 60 demonstrated similar 5- and 8-year FFbF (95% and 92%) compared with men >60 (93% and 87%; p = 0.071). A larger percent of young patients presented with low-risk disease; lower clinical stage, Gleason score (GS), and pretreatment PSA values; were treated after 1997; did not receive any HT; and had a high biologic effective dose (BED) of radiation (all ps <0.001). On multivariate analysis, PSA (p = 0.001), GS (p = 0.005), and BED (p < 0.001) were significantly associated with FFbF, but age was not (p = 0.665).ConclusionYoung men achieve excellent 5- and 8-year biochemical control rates that are comparable to those of older men after prostate brachytherapy. Young age should not be a deterrent when considering brachytherapy as a primary treatment option for clinically localized prostate cancer.Copyright 2010 Elsevier Inc. All rights reserved.

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