Journal of Radiotherapy in Practice

Table of Contents - March 2012 - Volume 11, Issue 01  

Original Article

Long-term experience with 181 patients who received transperineal I-125 implants for prostate cancer: Efficacy and urinary toxicity

Eliahu Geza1 c1, Joshua Genesina2, Daniel Shahara1, Valeriya Semenistya1, Tanya Mashiaca3, Rachel Bar Deromaa1, David Kakiashvilia2, Abraham Kutena1 and Simon Meretycka2

a1 Division of Oncology, Rambam Health Care Campus, Haifa, Israel

a2 Department of Urology, Rambam Health Care Campus, Haifa, Israel

a3 Quality Assurance Unit, Rambam Health Care Campus, Haifa, Israel

Abstract

Background: In low-risk prostate cancer, the target volume for radiotherapy is the prostate gland only and prostate brachytherapy with an I-125 implant provides the most conformal radiotherapy.

Methods: Patients underwent a pre-implant prostate volume study from which a treatment plan was developed 2 weeks prior to implant. A dosimetric study was performed 1 month following the implant. The prescription dose was 145 Gy with the 95% isodose line covering the entire target volume. The maximal dose to the urethra was less than 210 Gy. Follow-up included serum PSA and IPSS evaluation every 3 months during the first year and then every 6 months beginning in the second year.

Results: During December 2000–March 2009, 181 patients with early prostate cancer underwent I-125 implant. The median post-implant PSA value of the entire cohort was 0.7 ng/ml. No patient developed clinical failure. In the follow-up, nine patients had biochemical failure according to the RTOG-ASTRO Phoenix definition (Nadir + 2.0 ng/ml). Of these, one patient refused hormonal therapy desiring to preserve sexual potency, and eight patients received hormonal therapy with a decreased serum PSA to 0.0 ng/ml. The treatment side effects were primarily urinary disturbances.

Conclusion: An I-125 implant is an effective and well-tolerated treatment and should be recommended for patients with low-risk prostate cancer.

Keywords

Correspondence:

c1 Correspondence to: Dr. Eliahu Gez, Division of Oncology, Rambam Health Care Campus, 8 Ha’Aliyah Street, Haifa 35254, Israel. E-mail: e_gez@rambam.health.gov.il

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