title: Safety and efficacy of iodine-125 permanent prostate brachytherapy in patients with J-pouch anastomosis after total colectomy for ulcerative colitis.
abstract: OBJECTIVE
  To ascertain the safety and efficacy of permanent prostate brachytherapy (PPB) in early prostate cancer patients who have undergone previous total proctocolectomy and J-pouch anastomosis for inflammatory bowel disease.
  
  
  METHODS
  We identified 10 patients with a previous history of prostate cancer and J-pouch anastomosis from our institutional review board-approved database. Seven patients had PPB and 3 had prostatectomy. Only patients treated with PPB were included. Patient records were reviewed to collect data on treatment-related toxicity and oncological outcomes.
  
  
  RESULTS
  All 7 patients who underwent PPB had low- to intermediate-risk prostate cancer. The mean prostatic volume was 24.40 mL and the average number of iodine-125 seeds implanted was 84. Postimplant dosimetric calculations showed a mean prostate volume receiving 100% of the prescribed dose (V100) of 88.76%, V150 of 45.23%, V200 of 16.79%, radiation dose delivered to 90% of the prostate of 147.89 Gy, volume of ileal pouch receiving 100% of the prescribed dose of 0.164 mL, and volume of ileal pouch receiving 50% of the prescribed dose of 1.38 mL. After a mean follow-up of 19 months, none of the patients had evidence of biochemical failure or clinical failure. There were no long-term genitourinary side effects detected. Two patients had Common Terminology Criteria for Adverse Events version 4.0 grade II gastrointestinal side effects, of which symptoms resolved to baseline in 1 patient, whereas the other patient progressed to chronic active enteritis (pouchitis).
  
  
  CONCLUSIONS
  Low- to intermediate-risk prostate cancer patients with J-pouch anastomosis after total colectomy for inflammatory bowel disease are candidates for definitive treatment with PPB. Caution should be exercised while deploying the most posterior row of seeds to minimize enteral pouch radiation doses.
authors.affiliation: Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio. Electronic address: cherias@ccf.org.
authors.forename: Sheen
authors.initials: S
authors.lastname: Cherian
authors.affiliation: Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Kittel
authors.affiliation: Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Chandana A
authors.initials: CA
authors.lastname: Reddy
authors.affiliation: Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Kolar
authors.affiliation: Department of Urology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: James
authors.initials: J
authors.lastname: Ulchaker
authors.affiliation: Department of Urology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Angermeier
authors.affiliation: Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Stephans
authors.affiliation: Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Rahul D
authors.initials: RD
authors.lastname: Tendulkar
authors.affiliation: Department of Urology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Eric
authors.initials: E
authors.lastname: Klein
authors.affiliation: Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Jay P
authors.initials: JP
authors.lastname: Ciezki
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D003082:Colectomy / Q000379:methods*; D003093:Colitis, Ulcerative / Q000628:therapy*; D006801:Humans; D007455:Iodine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000150:complications* / Q000532:radiotherapy
chemical_list: D007455:Iodine