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KMID : 1001020080060030127
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Journal of Urologic Oncology
2008 Volume.6 No. 3 p.127 ~ p.132
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Application of Low Dose Rate Brachytherapy in Locally Advanced Prostate Cancer
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Park Dong-Soo
Jang Woong-Ki
Oh Jong-Jin
Jee Sang Hyun
Shin Hyun-Soo
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Abstract
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Purpose: We have applied the low dose rate brachytherapy to locally advanced prostate cancer and evaluated the feasibility as a core treatment strategy in high- and very high-risk groups of prostate cancer patients.
Materials and Methods : A total of 50 consecutive patients have been treated with brachytherapy for one year since April 2007. Patients were classified using four risk stratifications of low, intermediate, high, and very high. Fifteen out of 23 patients were in high-risk group (clinical T3a-T3b or Gleason score 8-10 or PSA ＞20ng/ml) and 8 patients were in very high-risk group (clinical T3c-T4 or any T, N1-3). Iodine-125 Implantations were performed by practicing a real-time ultrasound guided seed placement including prostatic capsular and seminal vesicular placement. Eight out of 15 high-risk patients and all of the very high-risk patients received booster 45Gy external beam radiation. All of the 22 patients were treated with short-term androgen deprivation therapy.
Results: The median radiation doses delivered to 90% of the prostate (D90) in high-risk and very high-risk group were 197.5Gy (range: 142.5-357.5Gy) and 210Gy (range: 137.5-277.5Gy). Biochemical failure was not revealed in any case during follow up. All patients experienced no major complications.
Conclusions : We can expect outstanding local control in locally advanced prostate cancer by applying very high implant doses and modifying insertion field. Our technique of low dose rate brachytherapy would be feasible and tolerable in patients of high- and very high-risk groups. However, this strategy needs to have a long-term follow up data.
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KEYWORD
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Prostate, Cancer, Brachytherapy, Risk
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