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Open AccessArticle

Radiotherapy for Elderly Patients Aged ≥75 Years with Clinically Localized Prostate Cancer—Is There a Role of Brachytherapy?

1
Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
2
Department of Radiology, Ujitakeda Hospital, Uji-City, Kyoto 611-0021, Japan
3
Department of Radiation Oncology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka 540-0006, Japan
4
Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2018, 7(11), 424; https://doi.org/10.3390/jcm7110424
Received: 29 October 2018 / Revised: 5 November 2018 / Accepted: 5 November 2018 / Published: 8 November 2018
(This article belongs to the Section Nuclear Medicine & Radiology)
We compared radiotherapy outcomes between 241 elderly patients aged ≥75 years and 867 younger controls (age <75 years) with clinically localized prostate cancer. The elderly group showed an equivalent actuarial seven-year biochemical failure-free survival rate (7y-bNED) (94.9%) to the younger control group (96.4%, p = 0.593). The incidence of late genitourinary (GU) and gastrointestinal (GI) toxicities grade ≥2 was also similar between the elderly and younger cohorts, while no grade ≥4 adverse events occurred. We also examined the role of brachytherapy (BT) in the elderly group, in comparison with image-guided intensity-modulated radiotherapy (IG-IMRT). BT showed superior 7y-bNED (94.1%) than IG-IMRT (84.6%, p = 0.0183) in elderly patients, which was 100% (100% for BT and 100% for IG-IMRT, p > 0.999) for the low-risk group, 94.6% (92.8% and 100%, p = 0.203) for the intermediate-risk group, and 80.5% (91.2% and 73.6%, p = 0.0195) for the high-risk group. BT showed higher GU toxicity and equivalent GI toxicity to IG-IMRT. In conclusion, elderly patients showed bNED and toxicity that were equivalent to those observed in younger controls, and BT is a plausible option also for healthy elderly with potential to improve bNED, with higher but acceptable GU toxicity. View Full-Text
Keywords: prostate cancer; high dose rate; low dose rate; brachytherapy; IG-IMRT; elderly prostate cancer; high dose rate; low dose rate; brachytherapy; IG-IMRT; elderly
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MDPI and ACS Style

Yamazaki, H.; Masui, K.; Suzuki, G.; Nakamura, S.; Aibe, N.; Shimizu, D.; Nishikawa, T.; Okabe, H.; Yoshida, K.; Kotsuma, T.; Tanaka, E.; Otani, K.; Yoshioka, Y.; Ogawa, K. Radiotherapy for Elderly Patients Aged ≥75 Years with Clinically Localized Prostate Cancer—Is There a Role of Brachytherapy? J. Clin. Med. 2018, 7, 424.

AMA Style

Yamazaki H, Masui K, Suzuki G, Nakamura S, Aibe N, Shimizu D, Nishikawa T, Okabe H, Yoshida K, Kotsuma T, Tanaka E, Otani K, Yoshioka Y, Ogawa K. Radiotherapy for Elderly Patients Aged ≥75 Years with Clinically Localized Prostate Cancer—Is There a Role of Brachytherapy? Journal of Clinical Medicine. 2018; 7(11):424.

Chicago/Turabian Style

Yamazaki, Hideya; Masui, Koji; Suzuki, Gen; Nakamura, Satoaki; Aibe, Norihiro; Shimizu, Daisuke; Nishikawa, Tatsuyuki; Okabe, Haruumi; Yoshida, Ken; Kotsuma, Tadayuki; Tanaka, Eiichi; Otani, Keisuke; Yoshioka, Yasuo; Ogawa, Kazuhiko. 2018. "Radiotherapy for Elderly Patients Aged ≥75 Years with Clinically Localized Prostate Cancer—Is There a Role of Brachytherapy?" J. Clin. Med. 7, no. 11: 424.

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