Servicio de Oncología Radioterápica, Fundación Instituto Valenciano de Oncología (IVO), Valencia, España.
We review the experience with prostate carcinoma patients treated with permanent implants of 125-I seeds and the outcome eight years after the beginning of this technique.
From 2002 to 2007 we have performed 250 implants with LDR brachytherapy with RapidStrand(®) and preplanning system. Mean age was 68 (49-78). Mean PSA was 7.32 (2.31 - 14.6). T1-T2a was the stage in 98%, and Gleason ≤ 6 in 96%. Low risk cases were 81% and intermediate risk 19% (ten of them received 46Gy EBRT). Hormonal treatment was used in 42%.
With a mean follow-up of 48 months, 14 patients (5.7%) showed biochemical failure (BF). Eleven patients (4.5%) with theoretical BF were observed and PSA decreased without treatment. Actuarial PSA relapse-free survival at 5 years was 91%, (92% low risk, 86% intermediate cases), and 92% vs 81% with PSA < 10 vs >10 (p< 0.05). Rectum complications were G2 in 0.6%. A urinary catheter was necessary in 6.5%. Sexual function was conserved in 60%. Mean V100 was 89% and D90 143Gy.
The outcome of patients with low risk prostate carcinoma treated with I-125 seed is very good with very low complications rate. Cases with PSA bounces should be controlled before starting a salvage treatment.
Article in English, Spanish.
Guinot JL, Ricós JV, Gimeno J, Tortajada MI, Carrascosa M, Santos M, Casanova J, Soler P, Crispín V, Arribas L. Are you the author?
Reference: Actas Urol Esp. 2011 Apr 7. Epub ahead of print.