Tumor control and morbidity following transperineal iodine 125 implantation for stage T1/T2 prostatic carcinoma Journal Article
| Authors: | Wallner, K.; Roy, J.; Harrison, L. |
| Article Title: | Tumor control and morbidity following transperineal iodine 125 implantation for stage T1/T2 prostatic carcinoma |
| Abstract: | Purpose: To quantify disease progression and morbidity following computer tomography (CT)-based transperineal iodine 125 prostate implantation. Methods: Ninety-two patients with clinical stage T1 or T2, Gleason score 2 to 7/10, prostatic carcinoma had outpatient, CT-based transperineal 125I prostate implantation and were monitored for 1 to 7 years (median, 3). The prescribed minimum radiation dose was 140 to 160 Gy. Lymph node dissection and postimplantation prostatic biopsies were not routinely performed. Results: In 46% of patients, radiation-related urinary symptoms were substantial enough at 1 month following implantation to require medication. Radiation-related urinary symptoms gradually resolved. Two years after implantation, 14% of patients had persistent urinary symptoms of Radiation Therapy Oncology Group (RTOG) ≥ grade 2. Eight percent of patients underwent a transurethral resection of the prostate (TURP) within 2 years of implantation. Five patients developed radiation-induced rectal ulcerations. Of 56 patients who were sexually potent preimplantation, 86% retained potency at 3 years. Twenty-five patients had biochemical disease progression. The overall actuarial freedom from biochemical failure rate at 4 years following implantation was 63%. In Cox proportional hazards multivariate analysis, the strongest predictor of failure was prostate-specific antigen (PSA) level less than or greater than 10 ng/mL (P = .005), followed by Gleason score (2 to 4 v 5 to 7, P = .08) and stage (T1 v T2, P = .09). Conclusion: The 5-year biochemical freedom-from-progression rates following transperineal 125I implantation are comparable with those achieved with prostatectomy. The morbidity has decreased with increased physician experience. |
| Keywords: | adult; treatment outcome; aged; aged, 80 and over; middle aged; major clinical study; cancer radiotherapy; radiation dose; neoplasm staging; prostatic neoplasms; iodine 125; iodine radioisotopes; brachytherapy; cancer control; impotence; prostate carcinoma; perineum; interstitial radiation; humans; human; male; priority journal; article |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 14 |
| Issue: | 2 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 1996-02-01 |
| Start Page: | 449 |
| End Page: | 453 |
| Language: | English |
| PUBMED: | 8636756 |
| PROVIDER: | scopus |
| DOI: | 10.1200/JCO.1996.14.2.449 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 22 November 2017 -- Source: Scopus |
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