[High-dose-rate brachytherapy of prostatic carcinoma with iridium 192].
In the therapy of localized prostatic cancer the radical prostatectomy shows good results within a five-year interval with no evidence of disease in nearly 90%. An important alternative is the radiotherapy by external beam or interstitial technique with iodine, gold or iridium. We use the high dose rate technique with Ir-192. In this technique five to seven hollow needles are placed in the prostate from perineal punctures under transrectal sonographic control. The three-dimensional brachytherapy planning is done according the actual needle position. A computer program calculates the radiation dose and distribution for each needle by adjustment of time and stops of the Ir-implants. The Ir-192 is temporary loaded twice with 9 Gy supplemented with external beam radiation (18 x 2 Gy). Since 1985 29 patients with localized tumor (T1-T3, N0, M0) have been irradiated. 21/29 had a pelvic lymphadenectomy before. In 85% of the patients were seen no side effects. Only one patient had a serious complication through a recto-vesical fistula. Out of the 21 followed-up patients 16 were in full remission, three had an androgen deprivation because of progression. A local tumor control could be demonstrated by cytology in 70% of the patients. This rational technique seems to be an alternative for patients not eligible for a radical prostatectomy.
Schwarzer
J U
JU
Urologische Klinik und Poliklinik, Technische Universität München, Klinikum rechts der Isar.
Hofmann
R
R
Kneschaurek
P
P
Lukas
P
P
Lindner
A
A
Braun
J
J
D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D002277:Carcinoma / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy*; D005500:Follow-Up Studies; D006801:Humans; D007496:Iridium Radioisotopes / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D011881:Radiotherapy, Computer-Assisted; D012074:Remission Induction
D007496:Iridium Radioisotopes
High-dose-rate-Brachytherapie des Prostatakarzinoms mit Iridium 192.