13-year oncologic and functional outcomes and morbidity in men </= 55 years treated with I-125 brachytherapy +/- external beam radiation and/or androgen deprivation.
Bibliographic record
Abstract
121 Background: Young patients are most often recommended prostatectomy because few radiation series have reported long-term outcomes specifically for this age group. We now address that deficit by presenting single-institution 13-year oncologic outcomes and morbidity after I-125 prostate brachytherapy (BRT). Methods: Between 1998-2014, 227 patients < 55 years were prospectively followed after PCa treatment with BRT +/- external-beam irradiation +/- androgen deprivation. NCCN risk stratification identified 99 low-, 51 intermediate-, 77 high- + very-high-risk patients treated. Endpoints include Phoenix biochemical control (BC), prostate-cancer-specific survival (PCSS), overall survival (OS), and urinary, bowel, and sexual complications. Results: With a minimum and median follow-up of 26 and 72.3 months, respectively the 13-year actuarial rate of BC, PCSS, and OS for low-risk disease: 97.8%, 100%, 100%, respectively; for intermediate-risk disease: 94.0%, 100%, 88.1%, respectively and for high + very-high-risk disease 83.6%, 89.9%, 77.6%, respectively. Only 3 patients died of prostate cancer. Multivariate analysis demonstrated race, EBRT use, ADT use, PSA > 10, PSA > 20, GS > 7, T3a, T3b, smoking, diabetes as significant for BC and PCSS (p < 0.05). Permanent incontinence occurred only in the one patient who underwent TURP, 4 transient urethral strictures were all successfully dilated, and no other grade 3 intestinal or urinary complications were reported. In the 77.5 % potent at baseline, preservation was reported at 5 and 10-years overall in 75.8 % and 54.6 %, and with PDE5-I, 83.3% preserved potency at 10-years. Conclusions: Patients < 55 years achieve excellent and durable prostate cancer control at 13 years after I125 BRT, most notably in high-risk, with prostate cancer specific mortality uncommon in all but very-high-risk group. Significant urinary or bowel morbidity is uncommon, and potency preservation is expected with PDE5-I. We conclude age < 55 years should not be used to discriminate against LDRBT.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".