Study: Brachytherapy can control tumor rates in patients at risk for extracapsular cancer extension

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According to a recent study published in the medical journal Cancer, high tumor control rates are possible with external beam radiation followed by brachytherapy. The study investigated long-term outcomes from prostate cancer treatment with increased risk of extracapsular cancer extension (ECE) using brachytherapy-based treatment, as reported by Reuters Health.

The researchers examined 243 patients, who had at least one higher risk feature for ECE. 119 patients had intermediate-risk disease and 124 had high-risk disease. The patients received pelvic three-dimensional conformal external beam radiation followed by a palladium boost. Generous brachytherapy margins were utilized.

The nonfailing patient follow-up period was one and 14 years. "These patients have been followed longer than any other treatment group reported in the prostate-specific antigen," said Michael Dattoli, MD, lead investigator of the study to Reuters Health.

Overall actuarial freedom at 14 years was 81 percent, including 87 percent and 72 percent having intermediate and high-risk disease, respectively. Absolute risk of failure decreased progressively, falling to one percent beyond 6 years after treatment and all failing patients had prostate biopsies without evidence of local recurrence.

The researchers concluded that high tumor control rates are possible with beam radiation followed by Pd-103 brachytherapy. The results suggest that brachytherapy-based treatment may be a desirable modality for patients at higher risk for ECE, which disproves the commonly-held perception.