Presentation and Outcomes of First-Degree Relatives Treated with Brachytherapy for Clinically Localized Prostate Cancer

Volume 1 - Issue 2

Oren Factor*, Nelson Stone and Richard Stock

Received: June 27, 2018;   Published: July 03, 2018

DOI: 10.32474/JUNS.2018.01.000107

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Abstract

Purpose: To determine if first-degree relatives treated with definitive radiation for clinically localized prostate cancers have similar baseline characteristics and clinical outcomes.

Methods: From a prospectively assembled database, we identified a set of first-degree relatives with clinically localized prostate adenocarcinoma. Patients were treated with brachytherapy with or without external beam radiation therapy. Biochemical failure was the primary outcome. Toxicities were measured with the International Prostate Symptom Score (IPSS) and Mount Sinai Erectile Function Score (MSEF).

Results: We identified 41 patients including 22 pairs of first-degree relatives. One family included 3 separately treated brothers. The median follow up was 72 months. Eight pairs of first-degree relatives presented with the same Gleason score, representing 36% of pairs. Eleven pairs of relatives (50%) fell in the same NCCN risk category. There were 4 total biochemical failures, representing 9.8% of the cohort. In a single pair of brothers both patients experienced a biochemical failure. Therefore, in two pairs of relatives (9.1%) a different biochemical outcome was experienced. In the pair of brothers who both experienced biochemical failure, both brothers developed metastatic disease. One of the brothers died due to prostate cancer. Amongst pairs of first-degree relatives, 10 pairs (52%) experienced a concordant change in IPSS relative to the average. Fifty percent of pairs experienced concordant changes in MSEF score.

Conclusion: First-degree relatives treated with radiation therapy did not present similarly. Outcomes appeared to be concordant amongst relatives. There was no suggestion of worse outcomes in patients with a brother or father having prostate cancer.

Keywords: Prostate cancer, Brachytherapy, Family History, Biochemical Recurrence, Radiation Therapy

Abbrevations: IPSS: International Prostate Symptom Score; MSEF: Mount Sinai Erectile Function Score; SNPs: Single Nucleotide Polymorphisms; NCCN: National Comprehensive Cancer Network; ADT: Androgen Deprivation Therapy; EBRT: External Beam Radiation Therapy; BCR: Biochemical Recurrence; PSA: Prostate-Specific Antigen

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