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Prostate brachytherapy: a three-year experience from the first 116 patients in Greece
A Rempelakos1, J Katsilieris, R Apatsidis
1Department of Urology, 2Department of Radiation Oncology, "Saint Savas" Anticancer Institute, Athens, Greece.
Summary
Transperineal ultrasonography-guided permanent brachytherapy for localized prostate cancer is well-tolerated, with low complication rates. This prostate cancer treatment shows minimal acute and chronic side effects, offering a safe alternative.
Area of Science:
- Oncology
- Radiation Oncology
- Urology
Background:
- Localized prostate cancer requires effective treatment options.
- Permanent brachytherapy offers a minimally invasive approach.
- Assessing treatment complications is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of transperineal ultrasonography-guided permanent brachytherapy.
- To analyze the complications associated with this prostate cancer treatment.
- To present findings from the initial cohort of 116 patients.
Main Methods:
- 116 patients with localized prostate cancer received transperineal ultrasonography-guided permanent implantation using I(125) seeds.
- A total implant dose of 145 Gy was delivered using peripheral loading technique.
- Follow-up included clinical exams and prostate-specific antigen (PSA) monitoring.
Main Results:
- No patients experienced incontinence; 7.7% had acute urinary retention.
- Transient urinary symptoms (dysuria, urgency, frequency) affected 55% initially, resolving within a year.
- Mild proctitis occurred in 2.5%; 67% of potent patients remained potent; 4% experienced biochemical relapse.
Conclusions:
- Prostate brachytherapy is well-tolerated with minimal complications.
- Prostate size predicts acute urinary retention; alpha-blockers may reduce its incidence.
- This method demonstrates a lower impotence rate compared to radical prostatectomy.
