Iodine-125 seed brachytherapy for early stage prostate cancer: A single-institution review - Abstract

PURPOSE: We are reporting the five-year biochemical control, toxicity profile and dosimetric parameters using iodine-125 low dose rate brachytherapy (BT) as monotherapy for early stage prostate cancer at a single institution.

MATERIAL AND METHODS: Between April 2006 and December 2010, 169 men with early stage prostate cancer were treated with BT. Biochemical failure was defined using the Phoenix definition (nadir + 2 ng/mL). Treatment-related morbidities, including urinary, rectal and sexual function, were measured, applying the International Prostate Symptom Score (IPSS), the 7-grade Quality of Life Scale (QoL) and medical status, the International Consultation on Incontinence Modular Questionnaire (ICIQ), the International Index of Erectile Function (IIEF-5) and the Common Terminology Criteria for Adverse Events (CTCAE v4.03). Seed migration and loss, dosimetric parameters and learning effects were also analyzed.

RESULTS: Medium follow-up time was 50 months (range, 1-85 months). The five-year biochemical failure rate was 7%. Acute proctitis rates were 19% (grade 1) and 1% (grade 2), respectively. The overall incidence of incontinence was 19% (mild), 16% (moderate) and < 1% (severe). An increase in IPSS ≥ 5 points was detected in 59% of patients, with 38% regaining their baseline. Seed dislocation was found in 24% of patients and correlated with D90 and V100. A learning curve was found for seed migration, D90 and V100. QoL correlated with the general health condition of patient, incontinence symptoms and IPSS.

CONCLUSIONS: BT for early stage prostate cancer offers excellent five-year biochemical control with low toxicities. QoL aspects are favorable. A learning curve was detected for procedural aspects but its impact on patient relevant endpoints remains inconclusive.

Written by:
Zuber S, Weiß S, Baaske D, Schöpe M, Stevens S, Bodis S, Zwahlen DR.   Are you the author?
Klinikum Chemnitz gGmbH, Klinik für Radio-Onkologie, Flemmingstrasse 2, D-09116, Chemnitz, Germany; The London Clinic, 22 Devonshire Place, London, W1G 6JA, UK; Kantonsspital Aarau AG, Tellstrasse 25/Postfach, CH-5001, Aaarau, Switzerland; Kantonsspital Graubünden, Loëstrasse 170, CH-7000, Chur, Switzerland. ; ; ; ; ; ; ;

Reference: Radiat Oncol. 2015 Feb 22;10(1):49.
doi: 10.1186/s13014-015-0349-0

PubMed Abstract
PMID: 25880809 Prostate Cancer Section