Iodine-125-seed implantation combined with external radiotherapy under potentially curative intention in patients with advanced stage-C prostatic cancer

We report on 18 patients, aged 43-77 years, with clinical stage-C adenocarcinoma of the prostate, primarily treated by pelvic lymphadenectomy and 125I-seed implantation. After lymphadenectomy, the staging assessment differed from the preoperative diagnosis as follows: 4 patients were classified as stage C; 6 as D1, and 8 as D2 (distant nodal metastases). The 4 patients, classified postoperatively as stage C, received no further treatment. 11 patients with a postoperative classification of stage D had additional external beam radiation to the pelvic and paraaortic lymph nodes with shielding of the implanted prostatic region. In addition, 8 of these 11 patients had hormonal therapy. The remaining 3 patients have been treated by combining interstitial irradiation with preoperative external beam radiotherapy; postoperative irradiation was supplemented when the lymph nodes were positive.