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Results of the first study to analyze 25 years’ worth of follow-up data after radiation therapy for men with prostate cancer indicated that late recurrence (after 10-year follow-up) is rare if prostate-specific antigen (PSA) is less than 0.2 ng/mL, the surgical PSA definition of cancer control, 15 years after treatment. 

“This study … confirms that results from this program are equal to that of radical prostatectomy, thus giving men a choice of treatment,” noted Frank A. Critz, MD, in a statement issued by Radiotherapy Clinics of Georgia (RCOG) in Atlanta. Critz, the founder and medical director of RCOG, was one of the four RCOG physicians conducting the study, which appeared in The Journal of Urology (2013;189[3]:878-883).

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From 1984 to 2000, 3,546 consecutive hormone-naïve men with prostate cancer received 125I prostate seed implants (initially retropubic, later transperineal) followed by external beam radiation. Median follow-up was 11 years; longest time to recurrence was at the 15.5-year follow-up. 

The 10-, 15-, 20-, and 25-year disease-free survival (DFS) rates were 75%, 73%, 73%, and 73%, respectively. These rates were comparable to those in two previous studies of patients undergoing radical prostatectomy, demonstrating that seed implant followed by external beam radiation therapy is as effective a treatment as radical prostatectomy.

In 313 men with recurrence who had undergone radiation 16 to 25 years earlier, 5% of recurrences were late. In men implanted via transperineal method since 1995, the 15-year DFS rate was 79%. ONA