Short-term morbidity from CT-planned transperineal I-125 prostate implants.

PURPOSE To summarize short-term morbidity and tumor response following transperineal CT-guided I-125 prostate implantation. METHODS AND MATERIALS Twenty-one patients were treated with CT-based transperineal I-125 prostate implantation between June, 1988 and May, 1990. An average of 75 I-125 seeds were placed, with an average activity of .62 mCi/seed. Symptoms were quantified after interviewing each patient in detail. RESULTS Nearly all patients developed substantial dysuria, nocturia and frequency from 2-24 weeks following implantation. Urinary symptoms usually resolved within 4-6 months of implantation. The one year actuarial potency rate among 18 patients who were potent prior to implantation was 94%. By 6 months after implantation, 14/17 patients (82%) with Stage B tumors had complete regression of palpable disease. Of 17 patients with Stage A or B tumors who presented with an elevated PSA, 76% returned to the normal range within 6 months of implantation. CONCLUSION CT-guided transperineal prostate implants entail moderate, temporary urinary and rectral morbidity. Short-term tumor responses are encouraging.

[1]  P. Walsh,et al.  Radical retropubic prostatectomy. Improved anastomosis and urinary continence. , 1990, The Urologic clinics of North America.

[2]  J. Lattimer,et al.  Complications and regression of primary tumor size with radiotherapy in prostatic cancer. , 1972, The Journal of urology.

[3]  J Roy,et al.  An improved method for computerized tomography-planned transperineal 125iodine prostate implants. , 1991, The Journal of urology.

[4]  C. Perez,et al.  Irradiation of carcinoma of the prostate localized to the pelvis: analysis of tumor response and prognosis. , 1980, International journal of radiation oncology, biology, physics.

[5]  C. Perez,et al.  Complications of definitive radiotherapy for carcinoma of the prostate. , 1980, International journal of radiation oncology, biology, physics.

[6]  R. B. Smith,et al.  Risk of urinary incontinence following radical prostatectomy. , 1983, The Journal of urology.

[7]  A. Porter,et al.  Prostate‐specific antigen: Monitoring the response of carcinoma of the prostate to radiotherapy with a new tumor marker , 1990, Cancer.

[8]  W. Whitmore,et al.  Complications of 125iodine implantation and pelvic lymphadenectomy in the treatment of prostatic cancer. , 1979, The Journal of urology.

[9]  L. Brady,et al.  125Iodine implantation after lymphadenectomy in early carcinoma of the prostate. , 1986, International journal of radiation oncology, biology, physics.

[10]  G. Edmundson,et al.  Pelvic lymphadenectomy and transperineal interstitial implantation of IR 192 combined with external beam radiotherapy for bulky stage C prostatic carcinoma. , 1989, International journal of radiation oncology, biology, physics.

[11]  R. Peschel,et al.  Iodine-125 implants versus external beam therapy for stages A2, B, and C prostate cancer. , 1988, International journal of radiation oncology, biology, physics.

[12]  E. Vaughan,et al.  Medical management of benign prostatic hyperplasia. , 1990, Urology.

[13]  H. Lepor Role of long-acting selective alpha-1 blockers in the treatment of benign prostatic hyperplasia. , 1990, The Urologic clinics of North America.

[14]  C. Perez,et al.  Tumor control in definitive irradiation of localized carcinoma of the prostate. , 1986, International journal of radiation oncology, biology, physics.

[15]  W. Shipley,et al.  Preoperative irradiation, lymphadenectomy, and 125iodine implantation for patients with localized carcinoma of the prostate. , 1986, International journal of radiation oncology, biology, physics.

[16]  W. Catalona,et al.  Nerve-sparing radical prostatectomy: evaluation of results after 250 patients. , 1990, The Journal of urology.

[17]  D. Kuban,et al.  I–125 interstitial implantation for prostate cancer. What have we learned 10 years later? , 1989, Cancer.

[18]  B. S. Barringer RADIUM IN THE TREATMENT OF CARCINOMA OF THE BLADDER AND PROSTATE: REVIEW OF ONE YEAR'S WORK , 1917 .

[19]  Transperineal seed-implantation guided by biplanar transrectal ultrasound. , 1990, Urology.