ABSTRACT
Objective To investigate the prognostic factors of biochemical relapse in patients with early stage prostate cancer after brachytherapy.Methods From December 2003 to December 2007,117 patients (age 51-84 years,median 73 years) with early stage prostate cancer underwent brachytherapy at our hospital.The PSA ranged from 0.4 to 47.6 μg/L (median,14.7 g/L),in which 75 cases with PSA＜ 20.0 μg/L and 42 cases with PSA≥20.0 μg/L.Clinical stage ranged from T1b to T2c.The prostate volume ranged from 13 to 69 ml (average,31 ml),and the percentage of positive biopsy cores was 8％ to 100％ (average,45％),in which 69 cases with a positivity＜50％ and 48 cases with a positivity≥50％.The D90 ranged from 106 to 170 Gy (average,142 Gy).And 6 patients were treated with external beam radiation in combination.The biochemical no evidence of disease (bNED) rate was recorded.And possible prognostic factors,including risk stratification,PSA,clinical stage,prostate volume,biopsy positivity and D90,were analyzed by using SPSS 19.0 software.Results The patients were followed up for 19 to 114 months (average,84 months; median,82 months).And biochemical relapse was observed in 33 cases (bNED rate,72％).The bNED rates in low-risk,intermediate-risk and high-risk groups were 86％,79％ and 64％,respectively and significant correlations were found between bNED rate and risk stratification (P=0.040).Moreover,the bNED rate was significantly higher in patients with the following factors,namely PSA＜20.0 μg/L (P =0.028),percentage of positive biopsy cores＜50％ (P =0.006) and high-dose implants (D90 ≥ 140 Gy) (P=0.009).Conclusions The long-term efficacy of brachytherapy in early stage prostate cancer is definite.Significant associations are found between bNED rate and risk stratification.And higher rates of biochemical relapse could be found in patients with PSA ≥ 20.0 μg/L,percentage of positive biopsy cores ≥ 50％ or D90＜ 140 Gy groups.
ABSTRACT
Introducción: El cáncer de próstata es la segunda causa de muerte por cáncer en los hombres. La determinación del Antígeno Prostático Específico (PSA) que permite detectar muchos tumores órgano-confinados, que hasta hace pocos años pasaban desapercibidos, ha llevado a la migración del diagnóstico hacia estadios más precoces de la enfermedad. La prostatectomía radical ha sido considerada tradicionalmente el tratamiento preferente para el cáncer de próstata localizado en los hombres con una esperanza de vida de 10 años o más. La radioterapia externa (RT) también se ha utilizado extensamente, principalmente en aquellos pacientes no pasibles a ser sometidos a procedimientos invasivos mayores por su elevado riesgo quirúrgico. Tanto la cirugía como la radioterapia externa han obtenido buenos resultados en el control del cáncer de próstata a largo plazo de acuerdo a series publicadas. Sin embargo parecería ser que la prostatectomia radical arrojado mejores resultados en función al periodo libre de enfermedad hasta evidenciarse progresión de la enfermedad. Objetivos: Comparar resultados obtenidos de la evolución de los pacientes con diagnostico de cáncer de próstata en estadio clínico localizado, que fueron tratados por una u otra modalidad. La comparación se realizo en función al periodo libre de enfermedad hasta presentar recidiva de enfermedad, ante pacientes del mismo grupo de riesgo. Materiales y métodos: Se realizó un estudio retrospectivo, analítico y documental de las historias clínicas de 139 pacientes con diagnostico de cáncer de próstata órgano confinado en el período comprendido entre marzo del 2001 y junio del 2010. Los pacientes fueron tratados quirúrgicamente o recibieron radioterapia conformada externa con una radiación promedio de7030 Gy (6500-7560 Gy). Con una edad promedio de 67 años y un seguimiento entre 12 meses y 9 años. Se valoro el periodo transcurrido libre de progresión de enfermedad hasta presentar recaída bioquímica...
Prostate cancer is the second leading cause of cancer death in men. Prostate specific antigen (PSA) determination can be used to detect organ confined tumors in earlier stages of disease. Radical prostatectomy has traditionallybeen considered as the preferred treatment for localized prostate cancer in men with life expectancy over 10 years. External radiation therapy (RT) has also been used extensively,mainly in patients with high surgical risk. Both surgery and radiotherapy have been successful in controlling prostate cancer, according to published series, but radical prostatectomy yielded better results according to disease free period. Objectives: To compare obtained results from the evolution of patients diagnosed with localizes prostate cancer, treated byeither modality. The comparison was carried out according to disease free interval until disease recurrence.Material and methods: A retrospective and documentary analysis was realized between March 2001 and June 2010,including 139 patients diagnosed with localized prostate cancer. The patients were treated surgically or with external radiotherapy, receiving a mean of 7030 Gy radiation (6500-7560 Gy). Patientshave a mean age of 67 years and have been monitored between 12 months and 9 years. Time elapsed free of disease progression without biochemical relapse were analyzed. Each treatment modality was compared with patients who have the same risk.Results: In low risk patients (55), 18 underwent surgical treatment, of which 16,6% observed biochemical recurrence...