Comparing PSA outcome after radical prostatectomy or magnetic resonance imaging-guided partial prostatic irradiation in select patients with clinically localized adenocarcinoma of the prostate.

摘要: Abstract Objectives To determine whether high-dose radiation delivered to a subvolume of the prostate gland (peripheral zone) using intraoperative magnetic resonance imaging-guided brachytherapy provided comparable 5-year prostate-specific antigen (PSA) control rates radical prostatectomy (RP) in select patients compared prospectively but nonrandomized setting. Methods Between 1997 and 2002, 322 196 with clinical Stage T1c, PSA less than 10 ng/mL, biopsy Gleason score 3 + 4 or less, without perineural invasion underwent RP brachytherapy, respectively, had 2-year minimal follow-up. Cox regression multivariable analysis was used evaluate initial therapy, pretreatment level, score, percentage positive biopsies, volume were predictors time post-therapy failure. failure estimated Kaplan-Meier method defined American Society for Therapeutic Radiology Oncology consensus definition. Results Only biopsies ( P = 0.02) significant predictor post-treatment However, distribution this parameter between brachytherapy-treated not significantly different chi-square 0.25). The therapy did predict 0.18). estimate 93% versus 95% log-rank 0.16) patients, respectively. Conclusions Despite only partial prostatic irradiation similar estimates found both RP-managed patients.