Patterns of use and patient characteristics: brachytherapy for localized prostate cancer in octo- and nonagenarians.

Roger Valdivieso; Katharina Boehm; Malek Meskawi; Alessandro Larcher; Zhe Tian; Marie-Elise Parent; Philip Wong; Markus Graefen; Francesco Montorsi; Maxine Sun; Fred Saad; Pierre I Karakiewicz

Patterns of use and patient characteristics: brachytherapy for localized prostate cancer in octo- and nonagenarians.

Roger Valdivieso ^{1, 2} Katharina Boehm ^{1, 3} Malek Meskawi ^{1, 2} Alessandro Larcher ^{1, 4} Zhe Tian ¹ Marie-Elise Parent ^{5, 6} Philip Wong ² Markus Graefen ³ Francesco Montorsi ⁴ Maxine Sun ¹ Fred Saad ² Pierre I Karakiewicz ^{1, 2}

1 Cancer Prognostics and Health Outcomes Unit

2 Department of Urology Université de Montréal

3 Martini-Klinik am Universitätsklinikum Hamburg-Eppendorf

4 IRCCS Ospedale San Raffaele

5 CRCHUM - Centre de recherche du Centre Hospitalier de l'Université de Montréal

6 INRS-IAF - Institut Armand Frappier

Abstract : Brachytherapy (BT) is a widely used treatment modality for elderly patients with localized prostate cancer (PCa). To describe the patterns of BT use in octo- and nonagenarians treated for localized PCa in the USA. We hypothesized that most individuals treated with BT should remain alive for at least 10 years. We also postulated that BT should ideally be administered as monotherapy. Using the Surveillance Epidemiology and End Results (SEER)-Medicare-linked database, 2701 octo- and nonagenarians treated with BT between 1992 and 2009 were identified. Cumulative incidence rates and smoothed cumulative incidence plots were used. In patients with low-risk characteristics, 40 % received BT alone; 27 % received BT combined with ADT; 19 % received BT and EBRT; and 14 % received BT combined with both ADT and EBRT. Of intermediate-to-high-risk patients, 19 % received BT alone; 16 % received BT combined with ADT; 19 % received BT combined with EBRT; and 45 % received BT together with ADT and EBRT. Overall survival rate was 79 and 47 % at 5 and 10 years. Less than half of elderly treated with BT remain alive at 10 years of follow-up. Moreover, the vast majority of those individuals not only receives BT, but is also exposed to two or even three combined therapy modalities. These findings are worrisome.

Keywords : Brachytherapy Elderly patient... Localized prost... Octo- and nonag... Prostate cancer Survival

Document type :

Journal articles

Domain :

Life Sciences [q-bio]

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https://hal-riip.archives-ouvertes.fr/pasteur-01351767
Contributor : Michel Courcelles <>
Submitted on : Thursday, August 4, 2016 - 4:47:46 PM
Last modification on : Wednesday, April 17, 2019 - 12:15:35 PM

Patterns of use and patient characteristics: brachytherapy for localized prostate cancer in octo- and nonagenarians.

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Patterns of use and patient characteristics: brachytherapy for localized prostate cancer in octo- and nonagenarians.

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