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

Published online by Cambridge University Press:  24 June 2011

Eliahu Gez ,
Joshua Genesin ,
Daniel Shahar ,
Valeriya Semenisty ,
Tanya Mashiac ,
Rachel Bar Deroma ,
David Kakiashvili ,
Abraham Kuten  and
Simon Meretyck
Eliahu Gez*
Affiliation:
Division of Oncology, Rambam Health Care Campus, Haifa, Israel
Joshua Genesin
Affiliation:
Department of Urology, Rambam Health Care Campus, Haifa, Israel
Daniel Shahar
Affiliation:
Division of Oncology, Rambam Health Care Campus, Haifa, Israel
Valeriya Semenisty
Affiliation:
Division of Oncology, Rambam Health Care Campus, Haifa, Israel
Tanya Mashiac
Affiliation:
Quality Assurance Unit, Rambam Health Care Campus, Haifa, Israel
Rachel Bar Deroma
Affiliation:
Division of Oncology, Rambam Health Care Campus, Haifa, Israel
David Kakiashvili
Affiliation:
Department of Urology, Rambam Health Care Campus, Haifa, Israel
Abraham Kuten
Affiliation:
Division of Oncology, Rambam Health Care Campus, Haifa, Israel
Simon Meretyck
Affiliation:
Department of Urology, Rambam Health Care Campus, Haifa, Israel
*
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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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

Prostate cancerI-125 implantIPSSPSA-free survival
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 11 , Issue 1 , March 2012 , pp. 16 - 22
Copyright
Copyright © Cambridge University Press 2012

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