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

Eliahu Gez*, Joshua Genesin, Daniel Shahar, Valeriya Semenisty, Tanya Mashiac, Rachel Bar Deroma, David Kakiashvili, Abraham Kuten, Simon Meretyck

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish
Pages (from-to)16-22
Number of pages7
JournalJournal of Radiotherapy in Practice
Volume11
Issue number1
DOIs
StatePublished - Mar 2012
Externally publishedYes

Keywords

  • I-125 implant
  • IPSS
  • PSA-free survival
  • Prostate cancer

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