title: Iodine-125 seed brachytherapy for early stage prostate cancer: a single-institution review.
abstract: OBJECTIVE
  We are reporting the five-year biochemical control, toxicity profile and dosimetric parameters using iodine-125 low dose rate brachytherapy (BT) as monotherapy for early stage prostate cancer at a single institution.
  
  
  METHODS
  Between April 2006 and December 2010, 169 men with early stage prostate cancer were treated with BT. Biochemical failure was defined using the Phoenix definition (nadir + 2 ng/mL). Treatment-related morbidities, including urinary, rectal and sexual function, were measured, applying the International Prostate Symptom Score (IPSS), the 7-grade Quality of Life Scale (QoL) and medical status, the International Consultation on Incontinence Modular Questionnaire (ICIQ), the International Index of Erectile Function (IIEF-5) and the Common Terminology Criteria for Adverse Events (CTCAE v4.03). Seed migration and loss, dosimetric parameters and learning effects were also analyzed.
  
  
  RESULTS
  Medium follow-up time was 50 months (range, 1-85 months). The five-year biochemical failure rate was 7%. Acute proctitis rates were 19% (grade 1) and 1% (grade 2), respectively. The overall incidence of incontinence was 19% (mild), 16% (moderate) and < 1% (severe). An increase in IPSS ≥ 5 points was detected in 59% of patients, with 38% regaining their baseline. Seed dislocation was found in 24% of patients and correlated with D90 and V100. A learning curve was found for seed migration, D90 and V100. QoL correlated with the general health condition of patient, incontinence symptoms and IPSS.
  
  
  CONCLUSIONS
  BT for early stage prostate cancer offers excellent five-year biochemical control with low toxicities. QoL aspects are favorable. A learning curve was detected for procedural aspects but its impact on patient relevant endpoints remains inconclusive.
authors.affiliation: Klinikum Chemnitz gGmbH, Klinik für Radio-Onkologie, Flemmingstrasse 2, D-09116, Chemnitz, Germany. mail@szuber.eu.|The London Clinic, 22 Devonshire Place, London, W1G 6JA, UK. mail@szuber.eu.
authors.forename: Simon
authors.initials: S
authors.lastname: Zuber
authors.affiliation: Klinikum Chemnitz gGmbH, Klinik für Radio-Onkologie, Flemmingstrasse 2, D-09116, Chemnitz, Germany. s.weiss@skc.de.
authors.forename: Susan
authors.initials: S
authors.lastname: Weiß
authors.affiliation: Klinikum Chemnitz gGmbH, Klinik für Radio-Onkologie, Flemmingstrasse 2, D-09116, Chemnitz, Germany. d.baaske@skc.de.
authors.forename: Dieter
authors.initials: D
authors.lastname: Baaske
authors.affiliation: Klinikum Chemnitz gGmbH, Klinik für Radio-Onkologie, Flemmingstrasse 2, D-09116, Chemnitz, Germany. m.schoepe@skc.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Schöpe
authors.affiliation: The London Clinic, 22 Devonshire Place, London, W1G 6JA, UK. s.stevens@thelondonclinic.co.uk.
authors.forename: Simon
authors.initials: S
authors.lastname: Stevens
authors.affiliation: Kantonsspital Aarau AG, Tellstrasse 25/Postfach, CH-5001, Aaarau, Switzerland. stephan.bodis@ksa.ch.
authors.forename: Stephan
authors.initials: S
authors.lastname: Bodis
authors.affiliation: Kantonsspital Graubünden, Loëstrasse 170, CH-7000, Chur, Switzerland. daniel.zwahlen@ksgr.ch.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Zwahlen
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy*; D000368:Aged; D001918:Brachytherapy; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011788:Quality of Life; D011874:Radiometry; D011879:Radiotherapy Dosage; D012189:Retrospective Studies
chemical_list: D007457:Iodine Radioisotopes