A first-degree family history of prostate cancer has no impact on the treatment outcomes of prostate cancer patients treated with brachytherapy, and patients with this type of family history have clinical and pathologic characteristics similar to men with no family history at all, according to a study published Jan. 1 in the International Journal of Radiation Oncology*Biology*Physics.
"This information is relevant for both physicians and patients with new diagnoses as they embark on complex treatment decisions," said the study’s lead author Christopher A. Peters, MD, a radiation oncologist at Northeast Radiation Oncology Center in Dunmore, Pa.
In the first of its kind study, researchers at the departments of radiation oncology and urology at Mount Sinai School of Medicine in New York City sought to determine if having a familial history of prostate cancer, which is defined as a clustering of prostate cancer cases within a family, had an impact on the prognosis of men treated with brachytherapy for clinically localized prostate cancer patients.
Researchers followed 1,738 prostate cancer patients, of which 187 had a family history of prostate cancer in a first-degree relative, for a median follow-up time of 60 months. They found that in the low-, intermediate- and high-risk groups, a family history of prostate cancer had little to no prognostic significance in men treated with brachytherapy. Previous studies done with prostate cancer patients receiving external beam radiation therapy or radical prostatectomy had similar findings.
The results showed that a total of 11 percent had a family history of prostate cancer in a first-degree relative.
For the low-risk patients, both groups had similar actuarial five-year freedom from biochemical failure (FFBF) (97.2 vs. 95.5 percent). For intermediate-risk patients, there was a trend toward improved biochemical control in men positive for family history (five-year FFBF 100 vs. 93.6 percent). For the high-risk patients, men with a positive family history had similar five-year FFBF (92.8 vs. 85.2 percent).
On multivariate analysis, family history was not significant; use of hormones, high biologic effective dose, initial prostate-specific antigen value and Gleason score were the significant variables predicting biochemical control, according to the authors.
Peters and colleagues concluded that “men with a positive family history have clinicopathologic characteristics and biochemical outcomes similar to those with sporadic disease.”