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Do androgen deprivation and the biologically equivalent dose matter in low‐dose‐rate brachytherapy for intermediate‐risk prostate cancer?
The objective of this study was to investigate the impact of the biologically equivalent dose (BED) on treatment outcomes after iodine‐125 low‐dose‐rate brachytherapy (LDR‐BT) with or without supplemental external beam radiotherapy (EBRT) and androgen deprivation therapy (ADT) for intermediate‐risk...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055153/ https://www.ncbi.nlm.nih.gov/pubmed/27456710 http://dx.doi.org/10.1002/cam4.820 |
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author | Tabata, Ryuji Kimura, Takahiro Kuruma, Hidetoshi Sasaki, Hiroshi Kido, Masahito Miki, Kenta Takahashi, Hiroyuki Aoki, Manabu Egawa, Shin |
author_facet | Tabata, Ryuji Kimura, Takahiro Kuruma, Hidetoshi Sasaki, Hiroshi Kido, Masahito Miki, Kenta Takahashi, Hiroyuki Aoki, Manabu Egawa, Shin |
author_sort | Tabata, Ryuji |
collection | PubMed |
description | The objective of this study was to investigate the impact of the biologically equivalent dose (BED) on treatment outcomes after iodine‐125 low‐dose‐rate brachytherapy (LDR‐BT) with or without supplemental external beam radiotherapy (EBRT) and androgen deprivation therapy (ADT) for intermediate‐risk prostate cancer (PCa). We retrospectively evaluated 292 Japanese patients. The impact of the BED and ADT on treatment outcomes was investigated. Cox proportional hazard models were used for univariate and multivariate analysis with biological progression‐free survival (bPFS) and clinical progression‐free survival (cPFS) as the primary outcome measures. The median follow‐up was 66 months. The bPFS and cPFS rates at 5‐/7‐years were 91.6/87.7% and 95.9/94.0%, respectively. When stratified by BED levels, the bPFS rates at 5‐/7‐years were 92.1/89.3% for <178.0 Gy(2,) and 91.2/86.0% for ≥178.0 Gy(2), respectively (P > 0.05). Based on ADT duration, the bPFS rates at 5‐/7‐years were 89.8/83.5%, 89.7/89.7%, and 97.5/97.5% for none, 1–3 months, and 4–12 months, respectively (P = 0.03). For the univariate analysis, the use of ADT and its duration were significant predictors for bPFS, whereas BED was not significant. A multivariate analysis did not indicate the use of ADT itself was significant, however, when covariates were accounted for by the duration of ADT, the longer use of ADT was found to significantly improve bPFS. Although cPFS was associated neither with the BED levels nor ADT duration (P > 0.05), ADT duration had a trend of improving cPFS (P = 0.053). The higher levels of BED did not significantly impact bPFS for intermediate‐risk PCa after LDR‐BT with or without supplemental EBRT and ADT. The longer duration of ADT could provide an additional benefit in the context of high‐dose irradiation generated by LDR‐BT. |
format | Online Article Text |
id | pubmed-5055153 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-50551532016-12-12 Do androgen deprivation and the biologically equivalent dose matter in low‐dose‐rate brachytherapy for intermediate‐risk prostate cancer? Tabata, Ryuji Kimura, Takahiro Kuruma, Hidetoshi Sasaki, Hiroshi Kido, Masahito Miki, Kenta Takahashi, Hiroyuki Aoki, Manabu Egawa, Shin Cancer Med Clinical Cancer Research The objective of this study was to investigate the impact of the biologically equivalent dose (BED) on treatment outcomes after iodine‐125 low‐dose‐rate brachytherapy (LDR‐BT) with or without supplemental external beam radiotherapy (EBRT) and androgen deprivation therapy (ADT) for intermediate‐risk prostate cancer (PCa). We retrospectively evaluated 292 Japanese patients. The impact of the BED and ADT on treatment outcomes was investigated. Cox proportional hazard models were used for univariate and multivariate analysis with biological progression‐free survival (bPFS) and clinical progression‐free survival (cPFS) as the primary outcome measures. The median follow‐up was 66 months. The bPFS and cPFS rates at 5‐/7‐years were 91.6/87.7% and 95.9/94.0%, respectively. When stratified by BED levels, the bPFS rates at 5‐/7‐years were 92.1/89.3% for <178.0 Gy(2,) and 91.2/86.0% for ≥178.0 Gy(2), respectively (P > 0.05). Based on ADT duration, the bPFS rates at 5‐/7‐years were 89.8/83.5%, 89.7/89.7%, and 97.5/97.5% for none, 1–3 months, and 4–12 months, respectively (P = 0.03). For the univariate analysis, the use of ADT and its duration were significant predictors for bPFS, whereas BED was not significant. A multivariate analysis did not indicate the use of ADT itself was significant, however, when covariates were accounted for by the duration of ADT, the longer use of ADT was found to significantly improve bPFS. Although cPFS was associated neither with the BED levels nor ADT duration (P > 0.05), ADT duration had a trend of improving cPFS (P = 0.053). The higher levels of BED did not significantly impact bPFS for intermediate‐risk PCa after LDR‐BT with or without supplemental EBRT and ADT. The longer duration of ADT could provide an additional benefit in the context of high‐dose irradiation generated by LDR‐BT. John Wiley and Sons Inc. 2016-07-25 /pmc/articles/PMC5055153/ /pubmed/27456710 http://dx.doi.org/10.1002/cam4.820 Text en © 2016 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Cancer Research Tabata, Ryuji Kimura, Takahiro Kuruma, Hidetoshi Sasaki, Hiroshi Kido, Masahito Miki, Kenta Takahashi, Hiroyuki Aoki, Manabu Egawa, Shin Do androgen deprivation and the biologically equivalent dose matter in low‐dose‐rate brachytherapy for intermediate‐risk prostate cancer? |
title | Do androgen deprivation and the biologically equivalent dose matter in low‐dose‐rate brachytherapy for intermediate‐risk prostate cancer? |
title_full | Do androgen deprivation and the biologically equivalent dose matter in low‐dose‐rate brachytherapy for intermediate‐risk prostate cancer? |
title_fullStr | Do androgen deprivation and the biologically equivalent dose matter in low‐dose‐rate brachytherapy for intermediate‐risk prostate cancer? |
title_full_unstemmed | Do androgen deprivation and the biologically equivalent dose matter in low‐dose‐rate brachytherapy for intermediate‐risk prostate cancer? |
title_short | Do androgen deprivation and the biologically equivalent dose matter in low‐dose‐rate brachytherapy for intermediate‐risk prostate cancer? |
title_sort | do androgen deprivation and the biologically equivalent dose matter in low‐dose‐rate brachytherapy for intermediate‐risk prostate cancer? |
topic | Clinical Cancer Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055153/ https://www.ncbi.nlm.nih.gov/pubmed/27456710 http://dx.doi.org/10.1002/cam4.820 |
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