[Indications for curietherapy of the prostate using permanent implants].
In the last decade, brachytherapy emerged as a particularly appealing new way ot treating localized prostate cancer. Recently published 10-12 years biochemical control results appear to be superimposable to the best percentages achieved by surgery or conformal radiotherapy, with a small percentage of complications. This applied to severely patients. Only patients with T1/T2, PSA < 10 ng/mL, and Gleason score < 7 should be proposed such a treatment. The potential benefit of exploring patients with a endorectal coil MRI is being evaluated. The number of positive biopsies is also a parameter which should probably be considered in the therapeutic choice. Moreover, a prostate volume > 60 g, hip mobility limitations, a urinary obstructive syndrome and previous transurethral resection lead to difficulties in technical implantation and therefore must be taken into account when discussing brachytherapy. In conclusion, for adequately selected patients, brachytherapy offers a particularly applied alternative to surgery and external radiotherapy, with satisfactory long term biochemical control rates and limited complications.
Chauveinc
L
L
Département de radiothérapie, institut Curie, 26, rue d'Ulm, 75005 Paris, France. laurent.chauveinc@curie.net
Flam
T
T
Solignac
S
S
Rosenwald
J C
JC
Thiounn
N
N
Firmin
F
F
Cosset
J M
JM
D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D001918:Brachytherapy / Q000295:instrumentation / Q000379:methods*; D003131:Combined Modality Therapy; D004343:Drug Implants; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009363:Neoplasm Proteins / Q000097:blood; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D020728:Transurethral Resection of Prostate; D014555:Urination Disorders / Q000209:etiology
D014408:Biomarkers, Tumor; D004343:Drug Implants; D009363:Neoplasm Proteins; D017430:Prostate-Specific Antigen