Postradiation biopsy and histological effects in early-stage prostatic cancer treated with 125iodine implants

One hundred twenty patients with adenocarcinoma of the prostate were treated with 125I irradiation to the prostate and pelvic lymphadenectomy. Clinical stages were A-2 (13 pts), B-1 (34 pts), B-2 (49 pts), and C-1 (24 pts). The tumors were well differentiated in 44%, moderately differentiated in 39% and poorly differentiated in 17%. Nineteen of 22 patients with positive lymph nodes had either moderately or poorly differentiated tumors. A total radiation dosage between 15,000 and 24,000 rads per year were given to all patients. Seventy-six patients had been rebiopsied at 1 year, and 26 were positive for malignancy (34%). Thirty-eight patients had rebiopsy at 2 years, and 16 were positive (42%). Forty-four percent of the postradiation biopsies were of a different histologic grade from the primary lesion. Radiation injury was identified in 95% of the posttreatment biopsies and were moderate or severe in 71%. One hundred one patients are living from 1 to 9 years. Eight patients have died of metastatic carcinoma, and 11 have died of cardiovascular problems.