Acute toxicity and preliminary therapeutic results of pelvic lymphadenectomy combined with transperineal interstitial implantation of 192IR and external beam radiotherapy for locally advanced prostate cancer.
We have developed a combined modality approach for treatment of locally advanced prostate cancer consisting of: surgical staging with lymphadenectomy; transperineal placement of afterloading needles for a course of 192Ir brachytherapy; and a course of moderate-dose external beam irradiation to tight prostatic fields. The flexibility of the treatment permits adaptation of the dose to any tumor configuration. A total of 23 patients have been treated to date; 18 are available for treatment review and 14 for acute toxicity analysis. Significant morbidity has occurred in only 2 patients, 1 with a pelvic hematoma and 1 with hematoma in the wound. Local tumor response has been excellent in all but 1 patient. A good degree of symptomatic improvement was observed at the three-month follow-up. This approach appears to be safe and effective at this time. A brief review of the technique and the rationale for its use are also presented.
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000601:surgery; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects; D003131:Combined Modality Therapy; D006801:Humans; D007495:Iridium / Q000008:administration & dosage*; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy* / Q000601:surgery; D011868:Radioisotopes / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed
D011868:Radioisotopes; D007495:Iridium