LDR-BT Boost Plus EBRT, ADT Improves Survival in High-Risk Prostate Cancer

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Low-dose-rate brachytherapy (LDR-BT), primarily as a boost in conjunction with external beam radiation therapy and androgen deprivation therapy, is highly effective in treating cT3a and cT3b high-risk prostate cancer, investigators concluded.

Their study involving 99 men found that LDR-BT is associated with excellent biochemical control and survival, according to Manuj Agarwal, MD, of the University of Maryland School of Medicine in Baltimore, and colleagues.

The men in the study had a median age of 69.4 years. They received either definitive LDR-BT or LDR-BT boost after EBRT from 1998 to 2007. About 86% received ADT. The median follow-up was 7 years.

The 7-year rate of freedom from biochemical failure (FFBF), prostate cancer-specific survival, and overall survival were 65.2%, 90.1%, and 77.9%, respectively, Dr Agarwal's team reported in Brachytherapy. Patients who received LDR-BT boost achieved a 7-year FFBF rate of 73.5%. The authors reported no significant difference in outcomes between men with cT3a and cT3b disease and no significant associations between outcomes and Gleason score, initial PSA, and percent core positive rates.

“LDR-BT boost implantation of patients should be strongly considered for cT3 patients given the merits of trimodality care,” the authors concluded.

Reference

Agarwal M, Chhabra AM, Amin N, et al. Long-term outcomes analysis of low-dose-rate brachytherapy in clinically T3 high-risk prostate cancer. Brachytherapy. Published online ahead of print.

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