Our Experience of Permanent Brachytherapy inLocalized Prostate Cancer

Abstract

Introduction: In this study, we present the short-term results of our brachytherapy series in patients with localized prostate cancer administered by a team led by urologists.Methods: Forty-one patients who underwent prostate brachytherapy between September 2003 and January 2007 were evaluated in this study. All patients had biopsy-proven adenocarcinoma. Low dose rate (LDR) Iodine-125 prostate brachyther-apy was performed under general anesthesia according to intraoperative-interactive planning and peripheral loading tech-nique. Preoperative and follow-up Prostate-Specific Antigen (PSA) levels, International Prostate Symptom Scores (IPSS) and International Index of Erectile Function-5 (IIEF-5) scores of all patients were determined.Results: Preoperative mean PSA, Gleason score and prostate volume of the patients were 7.7±5 ng/ml (4-22.5), 5.8±0.9 (4-8) and 36.8±12.6 ml (15-58 ml), respectively. The mean age of the patients was 62.3±6.3 (52-76) years. The mean follow-up period was 36.5 (7-60) months. Mean PSA value at the third (1.4±1.3 ng/ml) and sixth months (1.0±0.7 ng/ml) was signifi-cantly lower than preoperative mean PSA value (p<0.05). There was no significant difference between preoperative mean IPSS score (12.1±5.3) and mean IPSS scores at the third and sixth postoperative months (13.5±6.5 and 11.7±7.5, respectively, p>0.05). There was no significant difference between the mean preoperative IIEF score (14.2±2.6) and mean IIEF scores at the third and sixth postoperative months (11.3±6.5 and 10.8±7.5, respectively, p>0.05). TURP was performed in two patients after brachytherapy because of chronic urinary retention in one patient and because of increased lower urinary tract symptoms in other patient. One patient was referred to radiotherapy due to inadequate radioactivity in the dosimetric control tomography.Discussion and Conclusion: Brachytherapy is an effective method in the treatment of localized prostate cancer and it is recommended in current guidelines despite the recent decline in its use.