Permanent seed implantation for localized adenocarcinoma of the prostate.
Prostate brachytherapy has become a popular treatment option for localized prostate cancer with over 44,000 procedures performed in 2000. Eighty-seven percent to 93% of patients who have a serum prostate-specific antigen less than 10 ng/mL, Gleason score of 6 or less, and low risk (disease stage < or = T2a) can be expected to have an 8 to 10 year disease-free rate. The radiation dose delivered by the implants should exceed 140 Gy in men implanted with I-125 monotherapy. Patients with intermediate- and high-risk prostate cancer would benefit from the addition of either hormonal therapy and/or external beam irradiation to the implantation of seeds. Postimplant incontinence and proctitis can be minimized by controlling high radiation doses to the urethra and rectum. Potency is preserved in 70% of men with good preimplantation erectile function. Advances in technology, such as intraoperative dosimetry, will continue to make brachytherapy an attractive treatment option for men with localized prostate cancer.
Stone
Nelson N
NN
Department of Urology, Mount Sinai School of Medicine, One Gustave Levy Place, New York, NY 10029, USA. nproseed@aol.com
Stock
Richard G
RG
D000230:Adenocarcinoma / Q000532:radiotherapy*; D001918:Brachytherapy / Q000009:adverse effects / Q000639:trends; D005544:Forecasting; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000532:radiotherapy*