Permanent Prostate Brachytherapy for Localized High-risk Prostate Cancer Patients with Coronary Heart Disease: A 13-year Single-center Experience
Luo Yong, Li Mingchuan, Qi Hengzhi, Wei Nengbao, Zhao Jiahui, Cui Xinhao, Han Yili, Lin Yunhua, Hou Zhu, Jiang Yong-guang and Zhang Jiao
Correspondence Address :
Department of Urology, Beijing Anzhen Hospital,
Capital Medical University
Chaoyang District, Beijing, 100029, PR. China
Anatomy and Cell biology, East Carolina
Greenville, NC, USA, 27834
Received on: August 20, 2015, Accepted on: October 07, 2015, Published on: October 14, 2015
Citation: Luo Yong, Li Mingchuan, Qi Hengzhi, Wei Nengbao, Zhao Jiahui, Cui Xinhao, Han Yili, Lin Yunhua, Hou Zhu, Jiang Yong-guang, Zhang
Jiao (2015). Permanent Prostate Brachytherapy for Localized High-risk Prostate Cancer Patients with Coronary Heart Disease: A 13-
year Single-center Experience
Copyright: 2015 Zhang Jiao, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: To investigate whether permanent prostate brachytherapy (PPB) improves survival outcomes in localized high-risk prostate cancer (PCa) patients with coronary heart disease (CHD) via ameliorating prostate-specific antigen (PSA) kinetics.
Material and methods: We retrospectively reviewed the entire patient database regarding the survival and PSA kinetics of 216 consecutive localized PCa patients with clinical CHD who were treated from January 2001 to July 2012 at the Urology Department of the Beijing Anzhen Hospital. Kaplan-Meier analysis was used to calculate cause-specific survival (CSS) and overall survival (OS), and survival predictor was determined by log-rank and Cox-regression analyses. Differences in PSA kinetics and survival rate were compared between maximal androgen blockade (MAB)-treated cases and MAB + PPB-treated cases.
Results: The median follow-up time was 44 (range: 7-165) months. Brachytherapy, PSA nadir, and declining PSA were closely associated with survival. Compared with MAB monotherapy, combination therapy of MAB + PPB significantly ameliorated PSA kinetics. Additionally, MAB + PPB significantly improved the 13-year survival rate compared with MAB monotherapy (CSS: 56% vs. 13%; OS: 33% vs. 4%).
Conclusions: Combining PPB and MAB significantly increased the survival rates of localized high-risk PCa patients with CHD. PSA nadir ≤ 1 ng/mL and a >90% PSA decrease were independent prognostic factors for both CSS and OS.