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Brachytherapy in patients with small prostate glands.
D A Loblaw1, K Wallner, S Dibiase
1Radiation Oncology, Princess Margaret Hospital, University Health Network, University of Toronto, Ontario, Canada.
Techniques in Urology
|May 8, 2000
Summary
Prostate brachytherapy is safe and effective for patients with small prostates (less than 20 cc). This study found acceptable outcomes and target coverage, suggesting small prostate volume is not a contraindication for this treatment.
Area of Science:
- Urology
- Radiation Oncology
- Medical Physics
Background:
- Prostate brachytherapy is a treatment option for prostate cancer.
- Patient selection criteria for prostate brachytherapy are crucial for optimal outcomes.
- The role of small prostate volume in treatment selection requires further definition.
Purpose of the Study:
- To evaluate the efficacy and safety of prostate brachytherapy in patients with small prostate volumes (< 20 cc).
- To determine if small prostate volume is a contraindication for brachytherapy.
Main Methods:
- Thirty patients with prostate volumes < 20 cc underwent permanent isotope implantation.
- Transrectal ultrasound (TRUS) and postimplant CT scans were used for planning and verification.
- Dose prescriptions varied based on isotope (Iodine-125 or Palladium-103) and use of external beam radiation.
Main Results:
- Median coverage of the prostate by the prescription dose was 92%.
- Source migration rate was low (median of 2 sources).
- A median of 31 sources were identified outside the prostate margins on CT scans.
- Acute urinary retention occurred in one patient; AUA scores remained stable post-treatment.
Conclusions:
- Prostate brachytherapy demonstrates acceptable morbidity and target coverage in patients with small prostates.
- Small prostate volume should not be considered an absolute contraindication for brachytherapy.