Details

Autor(en) / Beteiligte

• Tang, Chad
• Sanders, Jeremiah
• Thames, Howard
• Swanson, David M
• Crook, Juanita M.
• Bruno, Teresa
• Blanchard, Pierre
• Ciezki, Jay
• Keyes, Mira
• Song, Daniel
• Singh, Tanmay
• Merrick, Gregory
• Stock, Richard
• Sullivan, Francis J.
• Mok, Henry
• Millar, Jeremy
• Frank, Steven J.

Titel

Outcomes after PD-103 versus I-125 for low dose rate prostate brachytherapy monotherapy: An international, multi-institutional study

Ist Teil von

• Radiotherapy and oncology, 2023-06, Vol.183, p.109599-109599, Article 109599

Ort / Verlag

Ireland: Elsevier B.V

Erscheinungsjahr

2023

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• •Access to the LDR brachytherapy isotope Pd-103 is limited outside the United States.•Pd-103 has radiobiological advantages over I-125 for prostate brachytherapy.•Use of Pd-103 LDR brachytherapy for prostate cancer led to better disease control than I-125.•These findings from a retrospective analysis need to be validated in a prospective trial. Pd-103 and I-125 are commonly used in low dose rate (LDR) brachytherapy for prostate cancer. Comparisons of outcomes by isotope type are limited, but Pd-103 has distinct radiobiologic advantages over I-125 despite its lesser availability outside the United States. We evaluated oncologic outcomes after Pd-103 vs I-125 LDR monotherapy for prostate cancer. We retrospectively analyzed databases at 8 institutions for men who received definitive LDR monotherapy with Pd-103 (n = 1,597) or I-125 (n = 7,504) for prostate cancer. Freedom from clinical failure (FFCF) and freedom from biochemical failure (FFBF) stratified by isotope were analyzed by Kaplan-Meier univariate and Cox multivariate analyses. Biochemical cure rates (prostate-specific antigen level ≤ 0.2 ng/mL between 3.5 and 4.5 years of follow-up) by isotype were calculated for men with at least 3.5 years of follow-up and compared by univariate and multivariate logistic regression. Compared with I-125, Pd-103 led to higher 7-year rates of FFBF (96.2% vs 87.6%, P < 0.001) and FFCF (96.5% vs 94.3%, P < 0.001). This difference held after multivariate adjustment for baseline factors (FFBF hazard ratio [HR] = 0.31, FFCF HR = 0.49, both P < 0.001). Pd-103 was also associated with higher cure rates on univariate (odds ratio [OR] = 5.9, P < 0.001) and multivariate (OR = 6.0, P < 0.001) analyses. Results retained significance in sensitivity analyses of data from the 4 institutions that used both isotopes (n = 2,971). Pd-103 monotherapy was associated with higher FFBF, FFCF, and biochemical cure rates, and suggests that Pd-103 LDR may lead to improved oncologic outcomes compared with I-125.