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Related Experiment Videos

Isotope selection for patients undergoing prostate brachytherapy.

C M Cha1, L Potters, R Ashley

  • 1Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center at Mercy Medical Center, Rockville Center, NY 11570, USA.

International Journal of Radiation Oncology, Biology, Physics
|September 16, 1999
PubMed
Summary
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This study found no significant difference in prostate cancer outcomes between Iodine-125 (125I) and Palladium-103 (103Pd) brachytherapy isotopes. Both isotopes demonstrated similar prostate-specific antigen relapse-free survival (PSA-RFS) in matched patients undergoing transperineal interstitial permanent prostate brachytherapy (TIPPB).

Area of Science:

  • Oncology
  • Radiation Oncology
  • Urology

Background:

  • Transperineal interstitial permanent prostate brachytherapy (TIPPB) utilizes either Iodine-125 (125I) or Palladium-103 (103Pd) isotopes.
  • In vitro studies suggest 125I for lower Gleason scores and 103Pd for higher scores, but clinical data comparing outcomes are limited.
  • Clinical practice varies, with some centers using specific isotope selection criteria and others using a single isotope regardless of Gleason score.

Purpose of the Study:

  • To compare treatment outcomes between 125I and 103Pd in patients undergoing TIPPB.
  • To evaluate the efficacy of isotope selection based on Gleason score.
  • To assess differences in prostate-specific antigen relapse-free survival (PSA-RFS) between the two isotopes.

Main Methods:

Related Experiment Videos

  • A matched pair analysis of 222 patients undergoing TIPPB between 1992 and 1997.
  • Patients were matched based on Gleason score, prostate-specific antigen (PSA) levels, and clinical stage.
  • PSA relapse-free survival (PSA-RFS) was calculated using the ASTRO Consensus Group definition; Kaplan-Meier curves were used for comparison.

    • Main Results:

    • Univariate analysis identified Gleason score, pretreatment PSA, and stage as significant predictors of PSA-RFS, but not isotope selection.
    • The 5-year actuarial PSA-RFS for the matched cohort was 86.5%, with no significant difference between 125I (85.9%) and 103Pd (87.1%) implants.
    • No significant differences in PSA-RFS were observed when comparing isotopes within different Gleason score or PSA subgroups, or in postimplant dosimetry (D90).

    Conclusions:

    • This matched pair analysis did not demonstrate a significant difference in PSA-RFS between 125I and 103Pd for TIPPB.
    • Neither isotope showed an observed advantage in low or high Gleason score groups.
    • The optimal role of isotope selection in TIPPB requires further clinical investigation.