Guided brachytherapy for treatment of confined prostate cancer

A total of 133 patients underwent transperineal ultrasound-guided iodine 125 seed implantation for Stages A and B prostate cancer with a twenty-seven-month follow-up. There has been no mortality and our morbidity is no more than experienced after transurethral resection of the prostate. By using a Mick applicator our operating time is well under one hour, and our patients go home the same day without a Foley catheter. Our results indicate that patients with PSA values of less than 20 ng/mL (Yang method) and/or Gleason scores of 6 or less are excellent candidates for brachytherapy. By subdividing the percentage of normal PSA values in the follow-up periods according to the patient's original PSA value, further credence is given to the PSA value as a strong aid in staging when the Gleason score is 6 or less. Although the follow-up at twenty-seven months is small, our preliminary results indicate that brachytherapy is a viable option to radical surgery in those patients who are not good candidates for surgery or who prefer nonsurgical treatment.