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RESEARCH PRODUCT

Permanent seed brachytherapy for clinically localized prostate cancer: long-term outcomes in a 700 patient cohort.

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Abstract Purpose Few large European studies have evaluated long-term outcomes for permanent prostate brachytherapy (PPB) as monotherapy for clinically localized prostate cancer. The objective of the present study was to evaluate long-term survival in this patient profile. Methods and Materials Retrospective study of 700 patients who underwent transperineal ultrasound-guided iodine-125 PPB (145 Gy) between January 2000 and July 2012. Median age was 64.8 years (range, 35–79). Most patients (638 of 700; 91%) had low-risk disease (D'Amico criteria). Eighty-five patients (12%) received hormonal treatment. Overall survival, cause-specific survival, and biochemical relapse–free survival were calculated and estimated using actuarial and Kaplan–Meier methods. Differences between groups were assessed using the log-rank test. Results Median followup was 63 months (range, 6–164). At 5- and 10-year followup, respectively, overall survival was 94% (95% confidence interval [CI], 92–96) and 84% (95% CI, 78–90); cause-specific survival was 100% and 97% (95% CI, 95–99); and biochemical relapse–free survival was 95% (95% CI, 93–97) and 85% (95% CI, 79–91). Conclusions The long-term results presented in this report confirm previous studies and provide additional support for the use of PPB in patients with favorable-risk prostate cancer. Seed brachytherapy provides excellent long-term results in this patient profile.