Outcomes of T3a Prostate Cancer with Unfavorable Prognostic Factors Treated with Brachytherapy Combined with External Radiotherapy and Hormone Therapy

Mai Zhi-peng; Yan* Wei-gang; Li Han-zhong; Zhou Yi; Zhou Zhi-en

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Outcomes of T3a Prostate Cancer with Unfavorable Prognostic Factors Treated with Brachytherapy Combined with External Radiotherapy and Hormone Therapy

Chinese Medical Sciences Journal Vol. 30, Issue 3, Pages: 143-149(2015)

Orginal Article | Updated：2024-04-10

- Outcomes of T3a Prostate Cancer with Unfavorable Prognostic Factors Treated with Brachytherapy Combined with External Radiotherapy and Hormone Therapy
- Affiliations：
  
  Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
- Author bio：
- Funds：
- DOI：
  CLC：
- Published Online：20 June 2015，
  
  Published：2015-06
- Accepted：
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Mai Zhi-peng, Yan* Wei-gang, Li Han-zhong, et al. Outcomes of T3a Prostate Cancer with Unfavorable Prognostic Factors Treated with Brachytherapy Combined with External Radiotherapy and Hormone Therapy[J]. Chinese medical sciences journal, 2015, 30(3): 143-149.
DOI：

Mai Zhi-peng, Yan* Wei-gang, Li Han-zhong, et al. Outcomes of T3a Prostate Cancer with Unfavorable Prognostic Factors Treated with Brachytherapy Combined with External Radiotherapy and Hormone Therapy[J]. Chinese medical sciences journal, 2015, 30(3): 143-149. DOI：

摘要

Abstract

Objective

To evaluate the outcomes of T3a prostate cancer with unfavorable prognostic factors treated with permanent interstitial brachytherapy combined with external radiotherapy and hormone therapy.

Methods

From January 2003 to December 2008

38 patients classified as T3a prostate cancer with unfavorable prognostic factors were treated with trimodality therapy (brachytherapy + external radiotherapy + hormone therapy). The prescription dose of brachytherapy and external radiotherapy were 110 Gy and 45 Gy

respectively. The duration of hormone therapy was 2-3 years. The endpoints of this study included biochemical failure-free survival (BFFS)

distant metastasis-free survival (DMFS)

cancer-specific survival (CSS)

and overall survival (OS). Survival curves were calculated using the Kaplan-Meier method. The Log-rank test was used to identify the prognostic predictors for univariate analysis.

Results

The median follow-up was 71 months. The serum pre-treatment prostate-specific antigen (PSA) level ranged from 10.0 to 99.8 ng/ml (mean 56.3 ng/ml)

the Gleason score ranged from 5 to 9 (median 8)

and the percentage of positive biopsy cores ranged from 10% to 100% (mean 65%). The 5-year BFFS

DMFS

CSS

and OS rates were 44%

69%

82%

and 76%

respectively. All biochemical failures occurred within 40 months. The percentage of positive biopsy cores was significantly correlated with BFFS

DMFS

and OS (all

=0.000)

and the Gleason score with DMFS (

=0.000) and OS (

=0.001).

Conclusions

T3a prostate cancer with unfavorable prognostic factors presents not so optimistic outcome. Hormone therapy should be applied to prolong the biochemical progression-free or metastasis-free survival. The percentage of positive biopsy cores and the Gleason score are significant prognostic factors.

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Keywords

references

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