Hayashi Narihiko, Izumi Koji, Sano Futoshi, Miyoshi Yasuhide, Uemura Hiroji, Kasuya Takeo, Mukai Akiko, Hata Masayuki, Inoue Tomio
Department of Urology, School of Medicine, Yokohama City University, Yokohama, Japan.
Department of Radiology, School of Medicine, Yokohama City University, Yokohama, Japan.
World J Urol. 2015 Oct;33(10):1519-26. doi: 10.1007/s00345-015-1480-0. Epub 2015 Jan 23.
To report 10-year outcomes of patients treated with I(125) low-dose-rate brachytherapy (BT) for clinically localized prostate cancer.
A group of 1,060 patients with clinically localized prostate cancer treated with I(125) BT between March 2004 and December 2013 at the Yokohama City University Hospital were identified. The records of 743 patients with a minimum of 2 years of follow-up were reviewed. Cohorts were categorized according to National Comprehensive Cancer Network risk classification, and biochemical outcomes plus overall survival were examined. Biochemical failure was defined as nadir prostate-specific antigen (PSA) level + 2 ng/mL. Univariate and multivariate Cox proportional hazards were used to determine predictors of biochemical failure.
A total of 743 patients met the criteria with a median follow-up of 54.6 months (range 24-114 months). The median age was 70 years (range 48-83). The 5- and 7-year overall survival rates were 98.8 and 97.6 %, and the 5- and 7-year biochemical failure-free survival rates were 92.6 and 91.0 %, respectively. With regard to distant metastases and survival, the 5- and 7-year metastatic-free survival rates were 98.2 and 95.9 %, respectively. A multivariate analysis revealed that initial PSA (p = 0.005; HR 1.097, 95 % CI 1.028-1.170), age (p = 0.001; HR 0.931, 95 % CI 0.893-0.971), and T stage (T1c vs. T2a) (p = 0.002; HR2.417, 95 % CI 1.319-4.267) were independent predictors of biochemical failure.
I(125) low-dose-rate BT resulted in excellent survival and morbidity outcomes for localized prostate cancer at a single institution. Further studies are needed to obtain long-term outcomes.
报告接受碘-125低剂量率近距离放射治疗（BT）的临床局限性前列腺癌患者的10年治疗结果。
确定了2004年3月至2013年12月期间在横滨市立大学医院接受碘-125 BT治疗的1060例临床局限性前列腺癌患者。回顾了743例至少随访2年患者的记录。根据美国国立综合癌症网络风险分类对队列进行分类，并检查生化结果和总生存率。生化失败定义为最低点前列腺特异性抗原（PSA）水平+2 ng/mL。使用单因素和多因素Cox比例风险模型来确定生化失败的预测因素。
共有743例患者符合标准，中位随访时间为54.6个月（范围24 - 114个月）。中位年龄为70岁（范围48 - 83岁）。5年和7年总生存率分别为98.8%和97.6%，5年和7年无生化失败生存率分别为92.6%和91.0%。关于远处转移和生存，5年和7年无转移生存率分别为98.2%和95.9%。多因素分析显示，初始PSA（p = 0.005；HR 1.097，95% CI 1.028 - 1.170）、年龄（p = 0.001；HR 0.931，95% CI 0.893 - 0.971）和T分期（T1c与T2a）（p = 0.002；HR2.417，95% CI 1.319 - 4.267）是生化失败的独立预测因素。
在单一机构中，碘-125低剂量率BT治疗局限性前列腺癌可带来良好的生存和发病结果。需要进一步研究以获得长期结果。
