TY - JOUR
T1 - Outcomes after PD-103 versus I-125 for low dose rate prostate brachytherapy monotherapy
T2 - An international, multi-institutional study
AU - Tang, Chad
AU - Sanders, Jeremiah
AU - Thames, Howard
AU - Swanson, David M.
AU - Crook, Juanita M.
AU - Bruno, Teresa
AU - Blanchard, Pierre
AU - Ciezki, Jay
AU - Keyes, Mira
AU - Song, Daniel
AU - Singh, Tanmay
AU - Merrick, Gregory
AU - Stock, Richard
AU - Sullivan, Francis J.
AU - Mok, Henry
AU - Millar, Jeremy
AU - Frank, Steven J.
N1 - Funding Information:
We would like to acknowledge Christine Wogan, MS, ELS, of MD Anderson’s Division of Radiation Oncology for her editorial contributions. Dr. C Tang is supported by the Cancer Prevention & Research Institute of Texas (RP180140 and RP200669) and is an Andrew Sabin Family Fellow. This research is also supported by the Cancer Center Support (Core) Grant P30 CA016672 from National Cancer Institute, National Institutes of Health to The University of Texas MD Anderson Cancer Center (PI: PW Pisters). This study was supported by Grant P30 CA016672 from the NCI, NIH.
Publisher Copyright:
© 2023
PY - 2023/6
Y1 - 2023/6
N2 - Background and Purpose: Pd-103 and I-125 are commonly used in low dose rate (LDR) brachytherapy for prostate cancer. Comparisons of outcomes by isotope type are limited, but Pd-103 has distinct radiobiologic advantages over I-125 despite its lesser availability outside the United States. We evaluated oncologic outcomes after Pd-103 vs I-125 LDR monotherapy for prostate cancer. Materials and Methods: We retrospectively analyzed databases at 8 institutions for men who received definitive LDR monotherapy with Pd-103 (n = 1,597) or I-125 (n = 7,504) for prostate cancer. Freedom from clinical failure (FFCF) and freedom from biochemical failure (FFBF) stratified by isotope were analyzed by Kaplan-Meier univariate and Cox multivariate analyses. Biochemical cure rates (prostate-specific antigen level ≤ 0.2 ng/mL between 3.5 and 4.5 years of follow-up) by isotype were calculated for men with at least 3.5 years of follow-up and compared by univariate and multivariate logistic regression. Results: Compared with I-125, Pd-103 led to higher 7-year rates of FFBF (96.2% vs 87.6%, P < 0.001) and FFCF (96.5% vs 94.3%, P < 0.001). This difference held after multivariate adjustment for baseline factors (FFBF hazard ratio [HR] = 0.31, FFCF HR = 0.49, both P < 0.001). Pd-103 was also associated with higher cure rates on univariate (odds ratio [OR] = 5.9, P < 0.001) and multivariate (OR = 6.0, P < 0.001) analyses. Results retained significance in sensitivity analyses of data from the 4 institutions that used both isotopes (n = 2,971). Conclusions: Pd-103 monotherapy was associated with higher FFBF, FFCF, and biochemical cure rates, and suggests that Pd-103 LDR may lead to improved oncologic outcomes compared with I-125.
AB - Background and Purpose: Pd-103 and I-125 are commonly used in low dose rate (LDR) brachytherapy for prostate cancer. Comparisons of outcomes by isotope type are limited, but Pd-103 has distinct radiobiologic advantages over I-125 despite its lesser availability outside the United States. We evaluated oncologic outcomes after Pd-103 vs I-125 LDR monotherapy for prostate cancer. Materials and Methods: We retrospectively analyzed databases at 8 institutions for men who received definitive LDR monotherapy with Pd-103 (n = 1,597) or I-125 (n = 7,504) for prostate cancer. Freedom from clinical failure (FFCF) and freedom from biochemical failure (FFBF) stratified by isotope were analyzed by Kaplan-Meier univariate and Cox multivariate analyses. Biochemical cure rates (prostate-specific antigen level ≤ 0.2 ng/mL between 3.5 and 4.5 years of follow-up) by isotype were calculated for men with at least 3.5 years of follow-up and compared by univariate and multivariate logistic regression. Results: Compared with I-125, Pd-103 led to higher 7-year rates of FFBF (96.2% vs 87.6%, P < 0.001) and FFCF (96.5% vs 94.3%, P < 0.001). This difference held after multivariate adjustment for baseline factors (FFBF hazard ratio [HR] = 0.31, FFCF HR = 0.49, both P < 0.001). Pd-103 was also associated with higher cure rates on univariate (odds ratio [OR] = 5.9, P < 0.001) and multivariate (OR = 6.0, P < 0.001) analyses. Results retained significance in sensitivity analyses of data from the 4 institutions that used both isotopes (n = 2,971). Conclusions: Pd-103 monotherapy was associated with higher FFBF, FFCF, and biochemical cure rates, and suggests that Pd-103 LDR may lead to improved oncologic outcomes compared with I-125.
KW - Brachytherapy
KW - I-125
KW - Low dose rate
KW - Pd-103
KW - Prostate Cancer
UR - http://www.scopus.com/inward/record.url?scp=85150041502&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85150041502&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2023.109599
DO - 10.1016/j.radonc.2023.109599
M3 - Article
C2 - 36889593
AN - SCOPUS:85150041502
SN - 0167-8140
VL - 183
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
M1 - 109599
ER -