PMID- 35123886
OWN - NLM
STAT- MEDLINE
DCOM- 20220707
LR  - 20220728
IS  - 1873-1449 (Electronic)
IS  - 1538-4721 (Linking)
VI  - 21
IP  - 4
DP  - 2022 Jul-Aug
TI  - Factors associated with late local failure and its influence on survival in men 
      undergoing prostate brachytherapy.
PG  - 460-467
LID - S1538-4721(22)00001-0 [pii]
LID - 10.1016/j.brachy.2022.01.001 [doi]
AB  - BACKGROUND AND PURPOSE: To determine the factors associated with a positive 
      post-treatment prostate biopsy (PB) and the effects of local failure on 
      biochemical control and cause-specific survival (CSS) in men receiving prostate 
      brachytherapy. METHODS AND MATERIALS: Of 545 men with post-implant PB, 484 were 
      routine (median 24 months) while 61 (median 55 months) were for cause. 114 had a 
      repeat PB for rising PSA. Initial mean PSA was 10.5 ng/ml (+/-13.9) while 244 
      (44.8%), 202 (37.1%) and 99 (18.2%) had low, intermediate or high-risk disease. 
      Treatments were implant only in 287 (52.7%), and implant with androgen 
      deprivation therapy (ADT) +/- external beam in 258. Radiation doses were converted 
      to the biologically equivalent dose (BED). Final biopsy results were the last 
      biopsy performed on that patient. Associations for the first and final biopsies 
      with PSA, clinical stage (CS), Gleason grade group, time on hormone therapy (ADT) 
      and BED were determined by ANOVA, chi-square and binary linear regression. 
      Freedom from Phoenix failure (FFPF) and cause-specific survival were estimated by 
      Kaplan Meier method and Cox proportions hazards. RESULTS: After a median of 11.4 
      years the first and final biopsy were positive in 10.8% and 8.8%, respectively. 
      Significant linear regression associations with first positive PB were ADT 
      (p = 0.005), CS (p = 0.044) and BED (p = 0.030) while only BED (p < 0.001) was 
      significant for the final PB. Positive biopsy occurred in 21/112 (18.8%), 16/230 
      (7.0%) and 3/182 (1.6%) for BED </=150, >150-200 and >200 Gy (p < 0.001), and in 
      29/261 (11.1%) for BED (median) </=185 Gy vs. 5/263 (1.9%) for > 185 Gy (OR 4.2, p 
      < 0.001). 15-year FFPF was 75.6 vs. 17.5% and cause-specific survival was 94.2 
      vs. 75.5% for negative vs. positive biopsy. CONCLUSIONS: Higher radiation doses 
      are associated with 1.9% late local failure following prostate brachytherapy. A 
      negative post-implant PB is associated with superior FFPF and decreased prostate 
      cancer mortality.
CI  - Copyright (c) 2022 American Brachytherapy Society. Published by Elsevier Inc. All 
      rights reserved.
FAU - Stone, Nelson N
AU  - Stone NN
AD  - Department of Urology Icahn School of Medicine at Mount Sinai (NNS), New York, 
      NY; Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai 
      (NNS), New York, NY. Electronic address: drnelsonstone@gmail.com.
FAU - Unger, Pamela D
AU  - Unger PD
AD  - Department of Pathology, Lenox Hill Hospital, Northwell Health, New York, NY.
FAU - Sheu, Rendi
AU  - Sheu R
AD  - Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai (NNS), 
      New York, NY.
FAU - Rosenstein, Barry S
AU  - Rosenstein BS
AD  - Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai (NNS), 
      New York, NY.
FAU - Stock, Richard G
AU  - Stock RG
AD  - Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai (NNS), 
      New York, NY.
LA  - eng
PT  - Journal Article
DEP - 20220203
PL  - United States
TA  - Brachytherapy
JT  - Brachytherapy
JID - 101137600
RN  - 0 (Androgen Antagonists)
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - IM
MH  - Androgen Antagonists/therapeutic use
MH  - *Brachytherapy/methods
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Prostate/pathology
MH  - Prostate-Specific Antigen/therapeutic use
MH  - *Prostatic Neoplasms
OTO - NOTNLM
OT  - Brachytherapy
OT  - Local failure
OT  - Prostate biopsy
OT  - Prostate cancer
OT  - Survival
EDAT- 2022/02/07 06:00
MHDA- 2022/07/08 06:00
CRDT- 2022/02/06 20:29
PHST- 2021/07/06 00:00 [received]
PHST- 2021/11/26 00:00 [revised]
PHST- 2022/01/05 00:00 [accepted]
PHST- 2022/02/07 06:00 [pubmed]
PHST- 2022/07/08 06:00 [medline]
PHST- 2022/02/06 20:29 [entrez]
AID - S1538-4721(22)00001-0 [pii]
AID - 10.1016/j.brachy.2022.01.001 [doi]
PST - ppublish
SO  - Brachytherapy. 2022 Jul-Aug;21(4):460-467. doi: 10.1016/j.brachy.2022.01.001. 
      Epub 2022 Feb 3.