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A. Y. Ho,
G. Fan. J. Cesaretti. N. Stone, R. Stock
Mount Sinai Medical Center, New York, NY
Purpose/Objective(s): Young age is commonly viewed as a negative prognostic factor in prostate cancer. Data supporting this perception is scant. Our goal was to ascertain 5-year biochemical outcomes in young men treated with low-dose rate prostate brachytherapy.
Materials/Methods: 1763 patients with clinically localized prostate cancer were treated with low-dose rate brachytherapy between 1990 to 2005 and had > 2 years of follow-up. Patients were stratified into three groups based on age: < 60 (n = 400). 61-75 (n = 1,142), and >75 (n = 221). Median follow-up for patients < 60,61-75 and >75 was 59 months (range 24-167), 62 months (range 24-181) and 54 months (range 24-197), respectively. Biochemical failure was defined by the ASTRO consensus definition. Univariate and multivariate Cox regression analyses were used to determine if any variable was predictive of 5-year bFFF. Variables included risk group (low vs. intermediate vs. high). Gleason score (< 6 vs. 7 vs. > 8), pretreatment prostate-specific antigen (PSA)(<10 vs. 10-20vs >20), treatment type (implant + hormones vs. implant and EBRT vs. trimodality), stage (< T2a vs T2b vs. > T2c), treatment era (1990-1997 vs: 1998-2005), use of hormonal therapy and biologically effective dose (BED < 150 vs. > 150). A two sided p-value <0.05 was consideredsignificant. Group comparisons was performed by Chi-square analysis.
Results: For the entire group;the actuarial 5-year bFFFwas 90%. On univariate analysis, patients < 60 years old demonstrated improved 5-year biochemical contro1 rates at 96% vs. patients in the 61-75 and >75 year old age groups at 89% and 88%, respectively (p =0.001). Compared to patients >60 years old, a significantly higher proportion of younger patients presented with low risk disease (57.3% vs 39.6%,p < .001), were treated after 1997 (72.3% vs 60.1 %,p
< .001), received hormonal therapy (60.2% vs. 57.5%, p150 (92.5% vs 85.2%.p < .001). On multivariate analysis of the entire group, treatment era (p = -0.009) and BED (p = 0.001) were significant in predicting 5-year biochemical control, but age was not (p = 0.2).
Conclusions: Young men achieve excellent 5-year biocheinical control rates comparable to men >60 years old after prostate brachytherapy. Young age should not be a deterrant when considering brachytherapy as a primary treatment option.
Author Disclosure: A. Y. Ho. None; G. Fan, None; J. Cesaretti. None; N. Stone, None; R. Stock, None.
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