¹²⁵Iodine Implantation for Carcinoma of the Prostate: 5-Year Survival Free of Disease and Incidence of Local Failure

Abstract

Interstitial implantation with the 125iodine isotope has been used as definitive treatment in 115 patients with localized carcinoma of the prostate. The disease was staged surgically by bilateral pelvic lymphadenectomy in all of the patients. Followup has been for a minimum of 1 year and 64 patients have been followed for a minimum of 5 years. There has been no operative mortality in this series. Mean patient age at implantation was 63 years. Potency has been maintained in 31 of 46 patients (78 per cent) followed for a minimum of 5 years and 15 of 26 (58 per cent) followed for a minimum of 7 years. At 5 years the actuarial survival free of disease by surgical stage was 100, 81, 49 and 41 per cent for patients with stages A2, B, C and D1 disease, respectively. All 7 patients with stage B1 nodules followed to 5 years are free of disease. The actuarial survival free of disease by grade at 5 years was 95 per cent for patients with well, 65 per cent with moderately and 34 per cent with poorly differentiated tumors. Local failure was defined as palpable evidence of prostatic enlargement or irregularity with biopsy confirmation of neoplasm. Patients with positive biopsy plus normal or stable prostatic examinations were not considered local failures, although such patients are at high risk for failure in the future. The actuarial probability of local failure at 5 years was 0, 13, 27 and 44 per cent for patients with surgical stages A2, B, C and D1 disease, respectively, and 5, 23 and 43 per cent for those with well, moderately and poorly differentiated tumors, respectively. Based on our experience, interstitial implantation with 125iodine isotope is reserved for patients with well or moderately differentiated stage B lesions. The ultimate success of this treatment modality awaits 10 and 15 years of followup.

Iodine-125 Brachytherapy for Clinically Localized Prostate Cancer: A 5-Year Follow-Up of Outcome and Complications

“…Similar findings were reported by Morton and Peschel [9] and Schellhammer et al [3] who found disease-free survival rates of 84 and 81%, respectively, after 5 years for patients with clinical stage B tumours. The corresponding figures for patients with clinical stage C tumours were 38 and 49%, respectively [3,9]. Likewise, Weyrich et al [10] reported 10-year disease-free survival rates of 60% for stage B2 and of 25% for stage Ci tumours.…”

“…The initial results were claimed to be good and the complication rate low [3], Thus, interstitial radiation was suggested as an alternative to radical prostatectomy or external radiation therapy. This paper reports our experience of 125I seed implantation in 37 patients with clinically localized prostate cancer.…”

Survival of patients with localized prostate cancer treated with percutaneous transperineal placement of radioactive gold seeds: Stages A2, B, and C

“…reported as loo%, 81%, 49%, and 41% for patients with stage A2, B, C, and D, disease [20]. Following external beam radiotherapy, 5-year, disease-specific survival has been reported as loo%, loo%, 85%, 83%, and 70% for stage Al, A2, B1, B2 and C disease, respectively [14] At our institution using interstitial 19' Au radiotherapy, 5-year cancer-specific survival was 100% for stage A2 and B1, 90% for B2, and 76% for stage C.…”

Radiotherapy for Palliation of Locally Advanced Prostatic Carcinoma

“…Radiotherapy gives useful palliation in the treatment of bony metastases due to prostatic carcinoma (Hope-Stone, 1980) and may relieve ureteric ob- struction (Fossa, 1987). Radical radiotherapy to the prostate has been used extensively in patients with early prostatic carcinoma in an attempt to cure the disease (Bagshawe and Ray, 1983; Dobbs et id., 1985;Schellhammer et al, 1985). However, its use as a palliative measure in order to control distressing symptoms due to advanced local disease has received scant attention in the literature.…”