Temporary iridium-192 implant in the management of carcinoma of the prostate

Abstract

The controversy about the treatment of carcinoma of the prostate has increased in the last decade, with most urologists favoring radical prostatectomy rather than primary irradiation. Several reports of persistent tumors in 50% to 90% of patients after external irradiation and permanent iodine‐125 implantation of the prostate have been disturbing. From July 1977 to December 1985, 200 patients with adenocarcinoma of the prostate were treated by combining bilateral pelvic lymphadenectomy and temporary interstitial iridium‐192 implantation of the prostate, followed by external irradiation. Seventy‐four (36%) patients underwent biopsies of the prostate 4 months to 2 years after completion of the irradiation. Only 12 (16%) patients had persistent tumors. Complications were minimized subsequently by dose modifications.

Late rectal complications after prostate brachytherapy for localized prostate cancer

“…These complication rates in contemporary series were lower than the rates in early reports on rectal complications, which typically ranged from 6% to 21%. 9,24,28,29 At our institution, the 5-year rates of rectal complications among 263 patients who received prostate brachytherapy since 1998 were encouraging (grade 1, 12.8%; grade 2, 3.7%; grade 3, 0.4%; and grade 4, 0%) (Fig. 3).…”

“…14,[24][25][26][27] In early published experiences, late rectal morbidity rates were relatively high. 24,28,29 In the early experience of Wallner et al, the incidence of rectal ulceration approached 10%. 24 This subsequently decreased to approximately 1% in their later reports, presumably as they gained experience.…”

Clinical outcome in patients with prostate cancer treated with external beam radiotherapy and high dose-rate iridium 192 brachytherapy boost: A 6-year follow-up

“…The results are summarized in Table V. In addition, centres have reported their experience using the Syed free-style template technique [25,26]. There has been increasing experience with the use of HDR brachytherapy as a boost to external beam radiotherapy, and this has been evidenced in reports from a number of institutions of 5 years bNED survival in the range of 67 Á93%.…”

Primary Radiation Therapy in the Treatment of Localized Prostatic Cancer

“…Several new approaches tend to improve the local control by radiotherapy: conformal technique, boost externalbeam irradiation by brachytherapy (36,37), use of high energy protons (38), neutron irradiation (39,40), negative pi meson irradiation (41), and heavy-ion irradiation (42). The outcome could also be improved by the use of radiosensitizers or hyperthermia (43,44).…”