Effects of neoadjuvant hormonal therapy on prostate biopsy results after 125I and 103Pd seed implantation

N. N. Stone, R. G. Stock, P. Unger, J. Sylvester, D. Bostwick, W. Fair, Mark Garzotto, J. Moul, A. D'Amico

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Androgen ablation may improve the efficacy of radiation therapy. Patients and Methods: A total of 296 patients who had either 125I (206; 70%) or 103Pd (90; 30%) transperineal prostate brachytherapy (no external-beam radiation) had routine transrectal ultrasound-guided needle biopsy (minimum six cores) 2 years after treatment without regard to disease status. Neoadjuvant hormonal therapy (NHT: leuprolide acetate and flutamide) was used in 115 patients (39%) for 3 months prior to and 3 months after the implant. Results: Of the 296 patients, 30 (10%) had positive prostate biopsies. Biopsies were positive in 4 of 115 (3.5%) v 26 of 181 (14%) of those who received or had not received NHT, respectively (P = 0.002). When patients were separated into low risk (PSA ≤10 ng/mL, stage ≤T(2a), and Gleason score ≤ 6) and high risk (all others), it was seen that low-risk patients did not benefit from NHT (3.8 v 7.7% positive biopsy rate; P = 0.5) whereas high-risk patients did (3.4% v 21.1%; P = 0.003). Conclusion: Prostate brachytherapy yields high negative biopsy rates (90%) 2 years after treatment. Neoadjuvant hormonal therapy can improve the local control rates (as determined by biopsy) in patients undergoing 125I or 103Pd seed implantation. These results are most significant for patients who present with PSA >10 ng/mL, stage ≥ T(2b) diseases, or Gleason score ≥7 (high-risk status).

Original languageEnglish (US)
Pages (from-to)163-168+170
JournalMolecular Urology
Volume4
Issue number3
StatePublished - 2000
Externally publishedYes

Fingerprint

Neoadjuvant Therapy
Prostate
Seeds
Biopsy
Neoplasm Grading
Brachytherapy
Leuprolide
Flutamide
Needle Biopsy
Androgens
Radiotherapy
Radiation

ASJC Scopus subject areas

  • Urology

Cite this

Stone, N. N., Stock, R. G., Unger, P., Sylvester, J., Bostwick, D., Fair, W., ... D'Amico, A. (2000). Effects of neoadjuvant hormonal therapy on prostate biopsy results after 125I and 103Pd seed implantation. Molecular Urology, 4(3), 163-168+170.

Effects of neoadjuvant hormonal therapy on prostate biopsy results after 125I and 103Pd seed implantation. / Stone, N. N.; Stock, R. G.; Unger, P.; Sylvester, J.; Bostwick, D.; Fair, W.; Garzotto, Mark; Moul, J.; D'Amico, A.

In: Molecular Urology, Vol. 4, No. 3, 2000, p. 163-168+170.

Research output: Contribution to journalArticle

Stone, NN, Stock, RG, Unger, P, Sylvester, J, Bostwick, D, Fair, W, Garzotto, M, Moul, J & D'Amico, A 2000, 'Effects of neoadjuvant hormonal therapy on prostate biopsy results after 125I and 103Pd seed implantation', Molecular Urology, vol. 4, no. 3, pp. 163-168+170.
Stone NN, Stock RG, Unger P, Sylvester J, Bostwick D, Fair W et al. Effects of neoadjuvant hormonal therapy on prostate biopsy results after 125I and 103Pd seed implantation. Molecular Urology. 2000;4(3):163-168+170.
Stone, N. N. ; Stock, R. G. ; Unger, P. ; Sylvester, J. ; Bostwick, D. ; Fair, W. ; Garzotto, Mark ; Moul, J. ; D'Amico, A. / Effects of neoadjuvant hormonal therapy on prostate biopsy results after 125I and 103Pd seed implantation. In: Molecular Urology. 2000 ; Vol. 4, No. 3. pp. 163-168+170.
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abstract = "Background: Androgen ablation may improve the efficacy of radiation therapy. Patients and Methods: A total of 296 patients who had either 125I (206; 70{\%}) or 103Pd (90; 30{\%}) transperineal prostate brachytherapy (no external-beam radiation) had routine transrectal ultrasound-guided needle biopsy (minimum six cores) 2 years after treatment without regard to disease status. Neoadjuvant hormonal therapy (NHT: leuprolide acetate and flutamide) was used in 115 patients (39{\%}) for 3 months prior to and 3 months after the implant. Results: Of the 296 patients, 30 (10{\%}) had positive prostate biopsies. Biopsies were positive in 4 of 115 (3.5{\%}) v 26 of 181 (14{\%}) of those who received or had not received NHT, respectively (P = 0.002). When patients were separated into low risk (PSA ≤10 ng/mL, stage ≤T(2a), and Gleason score ≤ 6) and high risk (all others), it was seen that low-risk patients did not benefit from NHT (3.8 v 7.7{\%} positive biopsy rate; P = 0.5) whereas high-risk patients did (3.4{\%} v 21.1{\%}; P = 0.003). Conclusion: Prostate brachytherapy yields high negative biopsy rates (90{\%}) 2 years after treatment. Neoadjuvant hormonal therapy can improve the local control rates (as determined by biopsy) in patients undergoing 125I or 103Pd seed implantation. These results are most significant for patients who present with PSA >10 ng/mL, stage ≥ T(2b) diseases, or Gleason score ≥7 (high-risk status).",
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AU - Stock, R. G.

AU - Unger, P.

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AU - Fair, W.

AU - Garzotto, Mark

AU - Moul, J.

AU - D'Amico, A.

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N2 - Background: Androgen ablation may improve the efficacy of radiation therapy. Patients and Methods: A total of 296 patients who had either 125I (206; 70%) or 103Pd (90; 30%) transperineal prostate brachytherapy (no external-beam radiation) had routine transrectal ultrasound-guided needle biopsy (minimum six cores) 2 years after treatment without regard to disease status. Neoadjuvant hormonal therapy (NHT: leuprolide acetate and flutamide) was used in 115 patients (39%) for 3 months prior to and 3 months after the implant. Results: Of the 296 patients, 30 (10%) had positive prostate biopsies. Biopsies were positive in 4 of 115 (3.5%) v 26 of 181 (14%) of those who received or had not received NHT, respectively (P = 0.002). When patients were separated into low risk (PSA ≤10 ng/mL, stage ≤T(2a), and Gleason score ≤ 6) and high risk (all others), it was seen that low-risk patients did not benefit from NHT (3.8 v 7.7% positive biopsy rate; P = 0.5) whereas high-risk patients did (3.4% v 21.1%; P = 0.003). Conclusion: Prostate brachytherapy yields high negative biopsy rates (90%) 2 years after treatment. Neoadjuvant hormonal therapy can improve the local control rates (as determined by biopsy) in patients undergoing 125I or 103Pd seed implantation. These results are most significant for patients who present with PSA >10 ng/mL, stage ≥ T(2b) diseases, or Gleason score ≥7 (high-risk status).

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