title: [Prostate I-125 brachytherapy: critical evaluation of mid-term oncologic and functional results in 250 cases].
abstract: BACKGROUND
  Even if brachytherapy (BT) in low-risk prostate cancer (CaP) is a common practice since more than 20 and 10 years in U.S.A. and Italy, respectively, it is still an uncommon procedure because of the problems related to the organization and collaboration among urologists, radiotherapists and physics, to the competition of alternative therapies, to dogmatic and educational beliefs, and to the poor knowledge of this technique.
  
  
  METHODS
  Between May 1999 and September 2010, 250 patients with low risk CaP underwent I125BT using a "real time" approach; the seeds implantation was performed using Mick applicator, in the first 190 patients, and the "Quick-Link" technique in the last 60 cases. Oncologic results were reported in the first 150 cases with a mean follow-up of 95 months, while functional outcomes and complications were assessed in all the patients at different time points with a mean follow-up of 65 months.
  
  
  RESULTS
  A good quality implantation was assessed in 88% of patients (D90 >140 Gy). Overall, a biochemical failure was assessed, in accordance with Phoenix criteria, in 10 patients (6.6%). Among these patients, the prostatic biopsy showed a CaP in 6/10 patients, who underwent retropubic radical prostatectomy (4 pts) and external RT (2 pts); only one patient developed a systemic progression with secondary bone lesions and died after 122 months and 36 months from BT and RRP, respectively. The 4/10 patients with negative biopsy were treated with total androgen blockade (2 pts) and with watchful waiting (2 pts). Regarding functional results, we assessed a moderate incidence of irritative disorders (70%) during the first six months and a good recovery of erectile function after one year from surgery (78.8%).
  
  
  CONCLUSIONS
  Brachytherapy in the low-grade risk prostatic cancer represents a good alternative to RRP with excellent functional and oncologic results
authors.affiliation: Dipartimento di Chirurgia, S.C. Urologia, Ospedale San Paolo, Savona, Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Gastaldi
authors.forename: Luciano
authors.initials: L
authors.lastname: Chiono
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Gallo
authors.forename: Claudio
authors.initials: C
authors.lastname: Giberti
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000008:administration & dosage; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D001706:Biopsy; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes; D007558:Italy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010410:Penile Erection / Q000528:radiation effects; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D011788:Quality of Life; D011868:Radioisotopes; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D057832:Watchful Waiting
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D007457:Iodine Radioisotopes; D011868:Radioisotopes