Long-term results of a phase II trial of ultrasound-guided radioactive implantation of the prostate for definitive management of localized adenocarcinoma of the prostate (RTOG 98-05)

Colleen A. Lawton, Daniel Hunt, W. Robert Lee, Leonard Gomella, David Grignon, Michael Gillin, Gerard Morton, Thomas M. Pisansky, Howard Sandler

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Purpose: To evaluate the long-term effectiveness of transrectal ultrasound-guided permanent radioactive I125 implantation of the prostate for organ confined adenocarcinoma of the prostate compared with historical data of prostatectomy and external beam radiotherapy within a cooperative group setting. Methods and Materials: Patients accrued to this study had histologically confirmed, locally confined adenocarcinoma of the prostate clinical stage T1b, T1c, or T2a; no nodal or metastatic disease; prostate-specific antigen level of ≤10 ng/ml; and a Gleason score of ≤6. All patients underwent transrectal ultrasound-guided radioactive I125 seed implantation into the prostate. The prescribed dose was 145 Gy to the prostate planning target volume. Results: A total of 101 patients from 27 institutions were accrued to this protocol; by design, no single institution accrued more than 8 patients. There were 94 eligible patients. The median follow up was 8.1 years (range, 0.1-9.2 years). After 8 years, 8 patients had protocol-defined biochemical (prostate-specific antigen) failure (cumulative incidence, 8.0%); 5 patients had local failure (cumulative incidence, 5.5%); and 1 patient had distant failure (cumulative incidence, 1.1%; this patient also had biochemical failure and died of causes not related to prostate cancer). The 8-year overall survival rate was 88%. At last follow-up, no patient had died of prostate cancer or related toxicities. Three patients had maximum late toxicities of Grade 3, all of which were genitourinary. No Grade 4 or 5 toxicities were observed. Conclusions: The long-term results of this clinical trial have demonstrated that this kind of trial can be successfully completed through the RTOG and that results in terms of biochemical failure and toxicity compare very favorably with other brachytherapy published series as well as surgical and external beam radiotherapy series. In addition, the prospective, multicenter design highlights the probable generalizability of the outcomes.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume81
Issue number1
DOIs
StatePublished - Sep 1 2011
Externally publishedYes

Fingerprint

Prostate
implantation
Adenocarcinoma
toxicity
incidence
antigens
Prostate-Specific Antigen
radiation therapy
grade
Prostatic Neoplasms
Incidence
Radiotherapy
cancer
Neoplasm Grading
Brachytherapy
Prostatectomy
organs
planning
seeds
Seeds

Keywords

  • Brachytherapy
  • Low dose rate
  • Prostate

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Long-term results of a phase II trial of ultrasound-guided radioactive implantation of the prostate for definitive management of localized adenocarcinoma of the prostate (RTOG 98-05). / Lawton, Colleen A.; Hunt, Daniel; Lee, W. Robert; Gomella, Leonard; Grignon, David; Gillin, Michael; Morton, Gerard; Pisansky, Thomas M.; Sandler, Howard.

In: International Journal of Radiation Oncology Biology Physics, Vol. 81, No. 1, 01.09.2011, p. 1-7.

Research output: Contribution to journalArticle

Lawton, Colleen A. ; Hunt, Daniel ; Lee, W. Robert ; Gomella, Leonard ; Grignon, David ; Gillin, Michael ; Morton, Gerard ; Pisansky, Thomas M. ; Sandler, Howard. / Long-term results of a phase II trial of ultrasound-guided radioactive implantation of the prostate for definitive management of localized adenocarcinoma of the prostate (RTOG 98-05). In: International Journal of Radiation Oncology Biology Physics. 2011 ; Vol. 81, No. 1. pp. 1-7.
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AU - Morton, Gerard

AU - Pisansky, Thomas M.

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