Effect of Family History on Outcomes in Patients Treated With Definitive Brachytherapy for Clinically Localized Prostate Cancer
Received 25 February 2008; received in revised form 1 April 2008; accepted 7 April 2008. published online 08 August 2008.
Purpose
To determine the impact familial prostate cancer has on prognosis in men treated with brachytherapy for clinically localized prostate cancer.
Methods and Materials
A total of 1,738 consecutive patients with prostate cancer (cT1–3, N0/X, M0) received low-dose-rate brachytherapy alone or in combination with external beam radiation therapy or hormone ablation from 1992 to 2005. The primary end-point was freedom from biochemical failure (FFBF) using the Phoenix definition. Minimum follow-up was 2 years and the median follow-up was 60 months (range, 24–197 months).
Results
A total of 187 of 1,738 men (11%) had a family history of prostate cancer in a first-degree relative. For the low-risk patients, both groups had similar actuarial 5-year FFBF (97.2% vs. 95.5%, p = 0.516). For intermediate-risk patients, there was a trend toward improved biochemical control in men positive for family history (5-yr FFBF 100% vs. 93.6%, p = 0.076). For the high-risk patients, men with a positive family history had similar 5-year FFBF (92.8% vs. 85.2%, p = 0.124). On multivariate analysis, family history was not significant; use of hormones, high biologic effective dose, initial prostate-specific antigen value, and Gleason score were the significant variables predicting biochemical control.
Conclusions
This is the first study to examine the relationship of familial prostate cancer and outcomed in men treated with brachytherapy alone or in combination therapy. Men with a positive family history have clinicopathologic characteristics and biochemical outcomes similar to those with sporadic disease.
∗Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY
†Department of Urology, Mount Sinai School of Medicine, New York, NY
Reprint requests to: Christopher Albert Peters, M.D., Department of Radiation Oncology, Mount Sinai School of Medicine, 1184 5th Avenue, Box 1236, New York, NY 10029. Tel: (212) 241-7501; Fax: (212) 410-7194
Presented at the American Society for Therapeutic Radiology and Oncology 49th Annual Meeting, Oct 27–Nov 1, 2007, Los Angeles, CA.
ABSTRACT