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Current issues in techniques of prostate brachytherapy

D Nori¹, J Moni

¹Department of Radiation Oncology, New York Hospital, Cornell Medical Center, Flushing 11355, USA.

Seminars in Surgical Oncology

|November 14, 1997

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Prostate brachytherapy offers superior potency preservation and convenience for prostate cancer patients. This review details its techniques, patient selection, and outcomes, recommending it for good-risk cases.

Area of Science:

Oncology
Radiation Oncology
Urology

Background:

Prostate adenocarcinoma is the most common cancer in US men.
Brachytherapy provides conformal radiotherapy, dose escalation, and a convenient outpatient procedure.
Potency preservation rates with brachytherapy exceed those of external beam radiation therapy (EBRT) and surgery.

Purpose of the Study:

To review the advantages and limitations of temporary and permanent prostate brachytherapy.
To discuss planning and operative techniques for brachytherapy.
To analyze clinical outcomes and patient selection criteria for prostate brachytherapy.

Main Methods:

Review of temporary and permanent brachytherapy techniques, including ultrasound/CT-guided transperineal approaches.

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Description of basic steps: prostate volume assessment, activity determination, seed placement.

Analysis of patient data (stage T2a, 1990-1995) including pre-treatment PSA, Gleason grade, and stage.

Main Results:

Actuarial 5-year clinical freedom from relapse was 79% and biochemical freedom from relapse was 64% for stage T2a disease.
Potency was preserved in over 80% of patients.
Patients were categorized into good, intermediate, and poor risk groups based on clinical factors.

Conclusions:

Brachytherapy is recommended as a sole procedure for good-risk prostate cancer patients.
A combination of EBRT and brachytherapy is suggested for intermediate-risk patients.
Future research should focus on improved imaging and new isotopes.