I125 prostate brachytherapy--short-term results of the first 150 patients in Israel

Prostate cancer is the most common malignancy among adult men. The treatment of locally confined prostate cancer is either surgical or radiation therapy. In the last decade or so a renewed method has gained popularity among patients and physicians, the use of implantable I125 seeds into the prostate--named brachytherapy. METHOD: We describe our first 150 cases treated with I125 brachytherapy with a follow-up after 3-24 months, median of 15 months. Twenty patients had a combination of external beam radiation and brachytherapy. RESULTS: Nadir PSA values of < 0.5 ng/ml were noted in 89%. This is accepted as evidence of cure. In 6 men elevation of PSA was noted and interpreted as a recurrence of disease. Associated morbidity was mild to moderate focusing on lower urinary tract symptoms, for about 3 months. IPSS values, measuring urinary symptoms after 3 months, resembled baseline levels. Impotence developed in 1/3 of men as a result of treatment. This was assessed using a self-completed IIEF questionnaire. No major complications (WHO grade III-IV) were noted in either urinary system or lower gastro-intestinal tract. IN CONCLUSION: We describe initial experience with Brachytherapy for the treatment of prostate cancer in Israel. Our results compare favourably with those published in American literature and profess moderate impact on quality of life as well as transient effects on lower urinary tract symptoms, and a minimal impotence rate (1/3) developing as a result of treatment. These results compare favourably with morbidity rates cited for radical surgery or external beam radiotherapy.