Long-term urinary function after transperineal brachytherapy for patients with large prostate glands

Area of Science:

• Oncology
• Urology
• Radiation Oncology

Background:

• Prostate brachytherapy is a common treatment for prostate cancer.
• Patient selection criteria for brachytherapy often consider prostate gland size.
• Limited data exists on long-term outcomes for patients with larger prostate glands (>50 cm3).

Purpose of the Study:

• To evaluate longer-term postbrachytherapy morbidity in patients with prostate glands exceeding 50 cm3.
• To assess the technical success and complication rates of brachytherapy in this patient cohort.

Main Methods:

• Retrospective analysis of 33 patients with prostate volumes >50 cm3 treated with 125I or 103Pd brachytherapy between 1997-1998.
• Assessment of urinary symptoms using American Urological Association criteria.
• Monitoring for acute and long-term complications, including urinary retention and rectal issues.

Main Results:

• 12 patients (36%) experienced acute urinary retention, with 85% catheter-free by 1 month and only 1 patient (4%) by 1 year.
• No permanent urinary incontinence was observed.
• Two patients developed rectal fistulas; however, this was not strongly correlated with prostate volume.
• Serum prostate-specific antigen levels showed significant decline post-treatment.

Conclusions:

• Prostate brachytherapy in patients with larger prostate volumes (>50 cm3) is associated with moderate morbidity and satisfactory technical outcomes.
• Prostate volume alone may not be a valid criterion for excluding patients from brachytherapy.
• Further research is warranted to refine patient selection for brachytherapy.