PMID- 24143146
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20131021
LR  - 20211021
IS  - 1689-832X (Print)
IS  - 2081-2841 (Electronic)
IS  - 2081-2841 (Linking)
VI  - 5
IP  - 3
DP  - 2013 Sep
TI  - Predictors of distant metastasis after combined HDR brachytherapy and external 
      beam radiation for prostate cancer.
PG  - 127-33
LID - 10.5114/jcb.2013.37942 [doi]
AB  - PURPOSE: To determine predictors of distant metastases (DM) in prostate cancer 
      patients treated with high dose rate brachytherapy boost (HDR-B) and external 
      beam radiation therapy (EBRT). MATERIAL AND METHODS: From 1991 to 2002, 768 men 
      with localized prostate cancer were treated with HDR-B and EBRT. The mean EBRT 
      dose was 37.5 Gy (range: 30.6-45 Gy), and the HDR-B was 22 or 24 Gy delivered in 
      4 fractions. Univariate and multivariate analyses using a Cox proportional 
      hazards model including age at diagnosis, T stage, Gleason score (GS), 
      pretreatment PSA, biologically equivalent dose (BED), and use of androgen 
      deprivation therapy (ADT) was used to determine predictors of developing distant 
      metastases. RESULTS: The median follow-up time for the entire patient population 
      was 4.2 years (range: 1-11.2 years). Distant metastases were identified in 22/768 
      (3%) of patients at a median of 4.1 years. PSA failure according to the Phoenix 
      definition developed in 3%, 5%, and 14% of men with low, intermediate, and high 
      risk disease with a median time to failure of 3.8 years. Prostate cancer specific 
      mortality was observed in 2% of cases. T stage, GS, and use of ADT were 
      significantly associated with developing DM on univariate analysis. GS, and use 
      of ADT were the only factors significantly associated with developing DM on 
      multivariate analysis (p < 0.01). Patients who received ADT had significantly 
      higher risk features suggesting patient selection bias for higher DM in this 
      group of patients rather than a negative interaction between HDR-B and EBRT. 
      CONCLUSIONS: In men treated with HDR-B and EBRT, GS is a significant factor on 
      multivariate analysis for developing distant metastasis.
FAU - Kamrava, Mitchell
AU  - Kamrava M
AD  - Department of Radiation Oncology, UCLA Medical Center, Los Angeles, USA.
FAU - Rwigema, Jean-Claude
AU  - Rwigema JC
FAU - Chung, Melody
AU  - Chung M
FAU - Banerjee, Robyn
AU  - Banerjee R
FAU - Wang, Jason
AU  - Wang J
FAU - Steinberg, Michael
AU  - Steinberg M
FAU - Demanes, David Jeffrey
AU  - Demanes DJ
LA  - eng
PT  - Journal Article
DEP - 20131002
PL  - Poland
TA  - J Contemp Brachytherapy
JT  - Journal of contemporary brachytherapy
JID - 101506276
PMC - PMC3797412
OTO - NOTNLM
OT  - brachytherapy
OT  - distant metastases
OT  - high-dose-rate
OT  - prostate cancer
EDAT- 2013/10/22 06:00
MHDA- 2013/10/22 06:01
PMCR- 2013/09/01
CRDT- 2013/10/22 06:00
PHST- 2013/07/26 00:00 [received]
PHST- 2013/09/20 00:00 [revised]
PHST- 2013/09/26 00:00 [accepted]
PHST- 2013/10/22 06:00 [entrez]
PHST- 2013/10/22 06:00 [pubmed]
PHST- 2013/10/22 06:01 [medline]
PHST- 2013/09/01 00:00 [pmc-release]
AID - 21485 [pii]
AID - 10.5114/jcb.2013.37942 [doi]
PST - ppublish
SO  - J Contemp Brachytherapy. 2013 Sep;5(3):127-33. doi: 10.5114/jcb.2013.37942. Epub 
      2013 Oct 2.