Permanent ¹²⁵I prostate brachytherapy for castration‐resistant prostate cancer

Abstract

Objective To evaluate the clinical significance of permanent 125I prostate brachytherapy in patients with castration‐resistant prostate cancer. Methods A retrospective study of 45 patients with castration‐resistant prostate cancer from the Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China was carried out. Patients were divided into two groups according to different treatments: 21 patients received endocrine therapy alone (control group), and 24 patients underwent brachytherapy combined with endocrine therapy (treatment group). Prostate‐specific antigen progression‐free survival, cancer‐specific survival, overall survival and quality of life of the two groups were compared. Results The median prostate‐specific antigen progression‐free survival and cancer‐specific survival of the treatment group were 29 months (interquartile range 25–37 months) and 37 months (interquartile range 30–50 months), respectively. These were significantly longer than those of the control group (both P < 0.05). Prostate‐specific antigen (before androgen deprivation therapy and before brachytherapy), prostate volume, Gleason score, clinical stage and brachytherapy were associated with prostate‐specific antigen progression‐free survival and cancer‐specific survival on univariate analysis. For the quality of life after treatment, urinary symptoms/problems at 1 month after brachytherapy compared with the control group had a statistically significant difference and clinically relevant deterioration, but after 6 months there were no statistically significant differences and clinically relevant deterioration. Compared with the control group, the physical functioning, social functioning, global health and general physical discomfort of the treatment group were significantly improved. Conclusions Brachytherapy with 125I seed implantation can effectively prolong survival of patients with castration‐resistant prostate cancer and, to a certain extent, improve patients’ quality of life.

CT-guided radioactive 125I seeds brachytherapy for lung oligometastases from colorectal cancer: initial results

“…This highly conformal brachytherapy can ensure accurate attack on the tumor while simultaneously protecting the surrounding normal tissues and organs at risk (OAR) to the greatest extent. RISB has been widely used in the local treatment of prostate cancer [ 8 ], lung cancer [ 9 ], pancreatic cancer [ 10 ], esophageal cancer [ 11 ], biliary cancer [ 12 ] and so on. What’s more, RISB for prostate cancer and brachytherapy stent loaded with 125 I seeds for malignant esophageal obstruction is recommended by some guidelines from the European Endoscopic Society and the Chinese Society for Esophageal Cancer Radiotherapy [ 13 , 14 ].…”

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“…A recent study confirmed the above conclusion that ING4 gene therapy combined with 125 I seed implantation effectively inhibited the growth and angiogenesis of pancreatic cancer (21). Similarly, prostate brachytherapy using 125 I seeds effectively prolonged life and significantly improved the quality of life of patients with prostate cancer (22). In summary, 125 I seed implantation has significant efficacy for the treatment of various cancers; thus, further studies to clarify the mechanism by which 125 I seed implantation inhibits malignant proliferation of tumor cells will be key to better defining the use of 125 I seed implantation for tumor treatment.…”