Brachytherapy for clinically localized prostate cancer: Results at 7- and 8-year follow-up

Abstract

In recent years, there has been a resurgence of interest in interstitial radiation as a cost‐effective and efficient method of treating organ‐confined prostate cancer. We describe our 7‐ and 8‐year results with transperineal Iodine‐125 and Palladium‐103 implantation. A total of 551 consecutive patients were treated. Of these, 320/551 (58%) received implant alone (Group I), and 231/551 (42%)—considered higher risk patients—were also treated with a modest dose (45 Gy) of external beam irradiation (Group II). The median follow‐up for Group I was 55 months, and for Group II, 60 months. At 7 years, the actuarial freedom from biochemical failure (prostate‐specific antigen (PSA)≤ 1.0 ng/mL) was 80% in Group I patients, and, at 8 years, 65% in Group II patients. Morbidity was minimal if patients had not undergone prior transurethral prostate resections. The results indicate that interstitial radiation is a valid treatment for clinically localized prostate cancer. Semin. Surg. Oncol. 13:438‐443, 1997. © 1997 Wiley‐Liss, Inc.

External-Beam Radiotherapy in the Management of Carcinoma of the Prostate

“…21,27,28 The currently available data for the modern era of prostate brachytherapy are represented by single-institution retrospective reviews that report their results in terms of PSA control outcomes (Table 2). 4,[28][29][30][31][32][33] Unfortunately, most results are presented in terms of institutionspecific criteria for PSA control. Even so, based on knowledge of pretreatment PSA levels, Gleason score, and T stage, most series have achieved effective stratification of patient groups to provide data by which selection of the optimal therapy according to defined prognostic variables can be based.…”

“…Early results reported excellent efficacy based on outcome measures of PSA control. 4,21,[26][27][28][29][30][31][32][33] It has been advocated that brachytherapy techniques represent the optimal method for conformal radiation therapy treatment delivery, based on the high irradiation doses that can be delivered directly to the prostate with a rapid fall-off in exposure to surrounding nontarget tissues. Conformal dose delivery represents the greatest strength of brachytherapy, but it is also the greatest limitation, as any disease that may extend outside of the implant volume will not receive effective irradiation.…”

Dosimetric parameters of three new solid core I‐125 brachytherapy sources

“…– 3 Due to the low energy of the emitted radiation, obtaining the dosimetric data necessary for clinical implementation can be challenging. The American Association of Physicists in Medicine (AAPM), through the Radiation Therapy Committee recommends that “… the dosimetric characteristics of each new product (i.e., commercial source) be evaluated by at least one, and preferably two, independent investigators other than the manufacturer.” 4 It is further recommended that “… a Monte Carlo study by an independent investigator should be made…” 4 and that the dosimetric data be presented in accordance with the recommendations of AAPM Task Group 43 5 .…”

Iodine seed prostate brachytherapy: an alternative first-line choice for early prostate cancer

“…[39][40][41][42] The primary complication of prostate brachytherapy is a temporary deterioration of urinary function with increased irritative and Iodine seed prostate brachytherapy SEM Langley and RW Laing obstructive symptoms. Patients are routinely treated with a-blockers.…”