High-dose-rate brachytherapy boost for elderly patients with intermediate to high-risk prostate cancer: 5-year clinical outcome of the PROSTAGE cohort.

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  • Deprecated function : Creation of dynamic property DatabaseCondition::$stringVersion is deprecated dans DatabaseCondition->compile() (ligne 1887 dans /home/gerontopcx/www/includes/database/query.inc).
  • Deprecated function : Creation of dynamic property DatabaseCondition::$stringVersion is deprecated dans DatabaseCondition->compile() (ligne 1887 dans /home/gerontopcx/www/includes/database/query.inc).
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TitreHigh-dose-rate brachytherapy boost for elderly patients with intermediate to high-risk prostate cancer: 5-year clinical outcome of the PROSTAGE cohort.
Publication TypeJournal Article
Year of Publication2022
AuthorsMarotte D, Gal J, Schiappa R, Gautier M, Boulahssass R, Chand-Fouche M-E, Hannoun-Lévi J-M
JournalClin Transl Radiat Oncol
Volume35
Pagination104-109
Date Published2022 Jul
ISSN2405-6308
Résumé

Purpose: To analyze the oncological outcome in elderly (>70 years) prostate cancer after high-dose rate brachytherapy (HDB) boost.Materials/methods: In this retrospective study, patients with intermediate (IR) and high-risk (HR) prostate cancer underwent external beam radiation therapy (EBRT) followed by HDB boost with/without androgen deprivation therapy (ADT). The impact of age (≤70y vs. > 70y) was investigated. Oncological outcome focused on biochemical relapse-free survival (bRFS), cause-specific (CSS) and overall survival (OS). Late genito-urinary (GU) and gastro-intestinal (GI) toxicities were investigated.Results: From 07/08 to 01/22, 518 pts received a HDB boost, and 380 were analyzed (≤70y:177pts [46.6%] vs. > 70y:203pts [53.4%]). Regarding NCCN classification, 98 pts (≤70y: 53pts; >70y: 45pts; p = 0.107) and 282 pts (≤70y: 124pts; >70y: 158pts; p = NS) were IR and HR pts respectively. Median EBRT dose was 46 Gy [37.5-46] in 23 fractions [14-25]. HDB boost delivered a single fraction of 14/15 Gy (79%). ADT was used in 302 pts (≤70y: 130pts; >70y: 172pts; p = 0.01). With MFU of 72.6 months [67-83] for the whole cohort, 5-y bRFS, 5-y CSS and 5-y OS were 88% [85-92], 99% [97-100] and 94% [92-97] respectively; there was no statistical difference between the two age groups except for 5-y CSS (p = 0.05). Late GU and GI toxicity rates were 32.4% (G ≥ 3 7.3%) and 10.1% (no G3) respectively.Conclusions: For IR and HR prostate cancers, HDB boost leads to high rates of disease control with few late G ≥ 3 GU/GI toxicities. For elderly pts, HDB boost remains warranted mainly in HR pts, while competing comorbidity factors influence OS.

DOI10.1016/j.ctro.2022.05.001
Alternate JournalClin Transl Radiat Oncol
PubMed ID35692263
PubMed Central IDPMC9184865