Palladium-103 brachytherapy for prostate carcinoma

Area of Science:

• Oncology
• Radiation Oncology
• Urology

Background:

• Prostate cancer management often involves brachytherapy, a localized radiation treatment.
• Palladium-103 (Pd-103) is a low-dose-rate isotope used in brachytherapy.
• Monitoring biochemical outcomes, particularly prostate-specific antigen (PSA) levels, is crucial for assessing treatment efficacy.

Purpose of the Study:

• To report biochemical outcomes in patients treated with Palladium-103 (Pd-103) brachytherapy for prostate cancer.
• To evaluate the long-term efficacy of Pd-103 brachytherapy based on prostate-specific antigen (PSA) levels.

Main Methods:

• A cohort of 230 patients with clinical stage T1-T2 prostate cancer received Pd-103 brachytherapy.
• Patients were monitored using prostate-specific antigen (PSA) determinations.
• Kaplan-Meier estimates and multivariate analysis were used to assess biochemical failure and risk factors.

Main Results:

• An overall biochemical control rate of 83.5% was achieved at 9 years.
• Significant risk factors for failure included pre-treatment PSA > 10 ng/ml and Gleason sum ≥ 7.
• Biochemical control rates varied based on the presence of these risk factors, with 94% for none, 82% for one, and 65% for both.

Conclusions:

• Pd-103 brachytherapy demonstrates high biochemical and clinical control rates in organ-confined prostate cancer.
• Prostate-specific antigen (PSA) response following low-dose-rate brachytherapy is a protracted process.
• Risk stratification using pre-treatment PSA and Gleason score aids in predicting treatment outcomes.