Combined brachytherapy and external beam radiotherapy without adjuvant androgen deprivation therapy for high-risk prostate cancerReport as inadecuate

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Radiation Oncology

, 9:13

Clinical Radiation Oncology


BackgroundTo report the outcomes of patients treated with combined iodine-125 I-125 brachytherapy and external beam radiotherapy EBRT for high-risk prostate cancer.

MethodsBetween 2003 and 2009, I-125 permanent prostate brachytherapy plus EBRT was performed for 206 patients with high-risk prostate cancer. High-risk patients had prostate-specific antigen ≥ 20 ng-mL, and-or Gleason score ≥ 8, and-or Stage ≥ T3. One hundred and one patients 49.0% received neoadjuvant androgen deprivation therapy ADT but none were given adjuvant ADT. Biochemical failure-free survival BFFS was determined using the Phoenix definition.

ResultsThe 5-year actuarial BFFS rate was 84.8%. The 5-year cause-specific survival and overall survival rates were 98.7% and 97.6%, respectively. There were 8 deaths 3.9%, of which 2 were due to prostate cancer. On multivariate analysis, positive biopsy core rates and the number of high-risk factors were independent predictors of BFFS. The 5-year BFFS rates for patients in the positive biopsy core rate <50% and ≥50% groups were 89.3% and 78.2%, respectively p = 0.03. The 5-year BFFS rate for patients with the any single high-risk factor was 86.1%, compared with 73.6% for those with any 2 or all 3 high-risk factors p = 0.03. Neoadjuvant ADT did not impact the 5-year BFFS.

ConclusionsAt a median follow-up of 60 months, high-risk prostate cancer patients undergoing combined I-125 brachytherapy and EBRT without adjuvant ADT have a high probability of achieving 5-year BFFS.

KeywordsProstate cancer Brachytherapy High risk Androgen deprivation therapy AbbreviationsEBRTExternal beam radiotherapy

ADTAndrogen deprivation therapy

BFFSBiochemical failure-free survival

CSSCause-specific survival

OSOverall survival

BEDBiologic effective doses


PSAProstate-specific antigen

Prostate D90Minimal dose received by 90% of the prostate




PCSMProstate cancer-specific mortality.

Electronic supplementary materialThe online version of this article doi:10.1186-1748-717X-9-13 contains supplementary material, which is available to authorized users.

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Author: Toshio Ohashi - Atsunori Yorozu - Shiro Saito - Tetsuo Momma - Toru Nishiyama - Shoji Yamashita - Yutaka Shiraishi - Naoyuk


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