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Li Y, Chan Kong Ngai T, Zhou S, Yap Haw Hwong J, Pang Pei Ping E, Ong Li Kuan A, Wang Lian Chek M, Chua Lee Kiang M, Looi WS, Nei WL, Chua ET, On WLK, Tan Wee Kiat T, Yuen Shyi Peng J, Tuan Kit Loong J. A comparative analysis between low-dose-rate brachytherapy and external beam radiation therapy for low- and intermediate-risk prostate cancer in Asian men. Acta Oncol 2021; 60:1291-1295. [PMID: 34259123 DOI: 10.1080/0284186x.2021.1950921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To report the long-term clinical outcomes of low-risk (LR) and intermediate-risk (IR) prostate cancer patients treated with low-dose-rate brachytherapy (LDR-BT) and external beam radiation therapy (EBRT). PATIENTS AND METHODS Men with biopsy-proven low- and intermediate-risk prostate cancer received EBRT and LDR-BT in an Asian academic center from 2000 to 2019 were reviewed. Kaplan-Meier survival analysis was performed to compare biochemical failure-free survival (bFFS) and overall survival (OS) between LDR and EBRT in the low- and intermediate-risk cohorts. RESULTS 642 patients (521 EBRT and 121 LDR-BT) with low- and intermediate-risk prostate cancer were included for analysis. In the intermediate-risk group, 5- and 10-year bFFS was 96%, 89% and 86%, 61% for LDR-BT and EBRT, respectively. LDR-BT was associated with a statistically significant improvement of bFFS in the intermediate-risk cohort (HR 2.7, p = 0.02). In the low-risk cohort, no difference of bFFS was found between LDR-BT and EBRT (HR 1.9, p = 0.08). Hormone therapy was more common in EBRT than LDR-BT for intermediate-risk group (71% versus 44%, p < 0.05). Prostate cancer-specific mortality was low in both EBRT (1%) and LDR-BT (2%) cohorts. No significant difference in OS was found between LDR-BT and EBRT in low- and intermediate-risk group (HR 2.1, p = 0.2 and HR = 1.7, p = 0.3). CONCLUSION In our retrospective study, LDR-BT is associated with superior bFFS compared with EBRT in Asian men with intermediate-risk prostate cancer.
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Affiliation(s)
- Youquan Li
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | | | - Siqin Zhou
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Jerome Yap Haw Hwong
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Eric Pang Pei Ping
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Ashley Ong Li Kuan
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Michael Wang Lian Chek
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Melvin Chua Lee Kiang
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Wen Shen Looi
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Wen Long Nei
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Eu Tiong Chua
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Weber Lau Kam On
- Duke-NUS Graduate Medical School, Singapore, Singapore
- Urology Centre, Singapore General Hospital, Singapore, Singapore
| | - Terence Tan Wee Kiat
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - John Yuen Shyi Peng
- Duke-NUS Graduate Medical School, Singapore, Singapore
- Urology Centre, Singapore General Hospital, Singapore, Singapore
| | - Jeffrey Tuan Kit Loong
- Department of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
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