Combined treatment with temporary short-term high dose rate iridium-192 brachytherapy and external beam radiotherapy for irradiation of localized prostatic carcinoma.
OBJECTIVE
To evaluate the treatment outcome after radical radiotherapy of localized prostate cancer in 50 patients (38 patients with stage T1-2 and 12 patients with stage T3) after a median follow-up time of 45 months (range 18-92 months).


METHODS
The treatment was given by combination of external beam radiotherapy (50 Gy) and brachytherapy (2 x 10 Gy). The brachytherapy was given using TRUS-guided percutaneously inserted temporary needles with a high dose rate remote afterloading technique with Ir-192 as the radionuclide source. Three target definitions and dose levels inside the prostate gland were used. Local control was evaluated by digital rectal examination, TRUS-guided biopsies and serum PSA evaluations.


RESULTS
Clinical and biopsy verified local control was achieved in 48 of the 50 (96%) patients; for stage T1-2 in 37 of 38 (97%) patients and for stage T3 in 11 of 12 (92%) patients. A posttreatment serum PSA level < or =1.0 ng/ml was seen in 42 (84%) patients, values from >1.0 to < or =2.0 ng/ml were seen in four (8%) patients and values exceeding 2.0 were seen in four (8%) patients. The late toxicity was minimal.


CONCLUSIONS
The local control results and the minimal toxicity after the combined radiotherapy treatment are promising. However, long term results are necessary before general use.
Borghede
G
G
Department of Oncology, Sahlgrenska University Hospital, Göteborg University, Sweden.
Hedelin
H
H
Holmäng
S
S
Johansson
K A
KA
Aldenborg
F
F
Pettersson
S
S
Sernbo
G
G
Wallgren
A
A
Mercke
C
C
D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D005767:Gastrointestinal Diseases / Q000209:etiology; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010410:Penile Erection / Q000528:radiation effects; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology; D016896:Treatment Outcome; D014555:Urination Disorders / Q000209:etiology
D007496:Iridium Radioisotopes; D017430:Prostate-Specific Antigen