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[Prostate brachytherapy: oncological and functional results after 400 cases]
Emilio Gastaldi1, Luciano Chiono, Fabrizio Gallo
1Dipartimento di Chirurgia, S.C. Urologia, Ospedale San Paolo, Savona - Italy.
Urologia
|March 26, 2014
Summary
Real-time brachytherapy (BT) offers excellent oncologic and functional outcomes for low and medium risk prostate cancer (CaP). This study shows BT is a viable alternative to radical prostatectomy, with a low biochemical failure rate and good recovery of erectile function.
Area of Science:
- Oncology
- Radiation Oncology
- Urology
Context:
- Brachytherapy (BT) for low and medium risk prostate cancer (CaP) is established but uncommon due to organizational, competitive, and educational barriers.
- Real-time I-125 BT technique has been practiced for over 15 years in Italy and 25 years in the USA.
Purpose:
- To evaluate the oncologic and functional outcomes of real-time I-125 brachytherapy in patients with low and medium risk prostate cancer.
- To assess the efficacy and safety of brachytherapy as an alternative to radical prostatectomy.
Summary:
- 400 patients with low/medium risk CaP underwent real-time I-125 BT between 1999-2013.
- Oncologic results (mean 10-year follow-up) showed a 4.8% biochemical failure rate (Phoenix criteria).
- Functional outcomes (minimum 1-year follow-up) indicated 70% postoperative irritative symptoms (resolving within 6 months) and good erectile function recovery (78.8% at 1 year, 68.2% at 5 years).
Impact:
- Brachytherapy demonstrates excellent oncologic control and favorable functional outcomes, supporting its role as a valuable alternative to radical prostatectomy for select prostate cancer patients.
- High-quality implantation (D90>145 Gy in 90% of cases) contributes to successful treatment.
