Detaillierte Beitrags-Information

Zurück zur Liste

Beitragstitel Long-term oncological and functional follow-up in low dose rate brachytherapy (LDR-BT) for prostate cancer: results from the prospective nation-wide Swiss LDR Prostate Brachytherapy Registry
Beitragscode M027
Autor:innen
  1. Pascal Viktorin Luzerner Kantonsspital Präsentierende:r
  2. Paul-Martin Putora KSSG Kantonsspital St. Gallen
  3. Hans-Peter Schmid KSSG Kantonsspital St. Gallen
  4. Ludwig Plasswilm KSSG Kantonsspital St. Gallen
  5. Christoph Schwab KSSG Kantonsspital St. Gallen
  6. Armin Thöni Lindenhofgruppe Bern
  7. Werner Hochreiter Hirslanden Klinik Aarau
  8. Ladislav Prikler Uroviva Bülach
  9. Stefan Suter Urologie Zug
  10. Patrick Stucki LUKS Luzern
  11. Nadja Blick Stadtspital Triemli, Zürich
  12. Hans Schiefer KSSG Kantonsspital St. Gallen
  13. Sabine Güsewell KSSG Kantonsspital St. Gallen
  14. Karin Zürn KSSG Kantonsspital St. Gallen
  15. Daniel Stephan Engeler Kantonsspital St. Gallen
Präsentationsform Freie Mitteilungen
Themengebiete
  • Prostata
Abstract-Text Background and Objective
LDR-BT is an effective therapy for organ-confined prostate cancer with comparable results to radical prostatectomy and external beam radiation therapy but results originate manly from single-center cohorts and retrospective analyses.
The Swiss Prostate LDR-Brachytherapy Registry (SPB) is a nationwide cohort with 12 centers all over Switzerland that operates a prospective data collection of LDR-BT patients since 09/2004 initially based on a regulatory requirement forwarded by the Swiss federal office of public health. The primary objective of the registry is to substantiate the oncologi-cal (biochemical recurrence free survival = BRFS) outcomes of LDR-BT in relation to risk factors and radiation dose with a prospective multicentric cohort.
Material and Methods
Data was collected at baseline, 6 weeks, 3, 6 and 12 months post-implantation and annually thereafter. Prostate cancer was categorized as low-, intermediate-, or high risk accord-ing to the D’Amico Classification. Functional outcomes were assessed.
LDR-BT was performed with 125-Iodine seeds. Dosimetry was performed 6 weeks after implantation based on the European Society for Radiotherapy and Oncology recommen-dations. Kaplan-Meier curves were used for BRFS with first PSA above the nadir + 2 as the date of relapse for biochemical failure (RTOG-ASTRO Phoenix Definition) and the last follow-up date.
Results
Of 1580 patients in the database, 1291 (81.7 %) were evaluable for therapy outcome. Me-dian follow up was 37.1 months (range 3.0 – 141.6). Higher BRFS was found for Gleason score ≤ 3+4 (p = 0.03, log rank test) and initial PSA level of < 10ng/ml (p < 0.001). D'Amico Risk groups were significant for recurrence (p < 0.001), with a hazard ratio 2.38 for a group of intermediate and high risk patients vs low risk. D90 after 6 weeks differed signifi-cantly in the group without (168.2 Gy) and the group with relapse (158.8 Gy). Functional outcomes and questionnaires showed a deterioration 6 weeks after BT with return to base-line after 3 years. Major limitation is a relevant loss in follow-up.
Conclusion
Our results are in line with other studies showing LDR-brachytherapy is associated with a low rate of therapy related toxicity and can be used as first line treatment. In order to provide a better therapy recommendation, prospective randomized controlled, multicenter studies with direct comparison of the different therapy options for localized prostate cancer would be necessary.