BOSTONMen who have large prostate glands may have slightly
more urinary symptoms after brachytherapy than men with smaller prostates, but
this should not deter such men from having the treatment, Nelson N. Stone, MD,
said at a poster session of the 42nd Annual Meeting of the American Society for
Therapeutic Radiology and Oncology (ASTRO).
Dr. Stone and Richard G. Stock, MD, of Mount Sinai School of
Medicine, New York, reviewed the outcomes of 242 men with T1-T2 prostate cancer
who were implanted with seeds containing I-125.
The patients ranged in age from 43 to 83 (median, 67). Prior to
treatment and every 6 months afterward, the patients recorded urinary symptoms,
using a scale of 0 to 5, with 5 being most severe. They also assessed quality
of life on a scale of 0 to 6. Follow-up was 18 to 180 months (median, 32).
Men with prostate glands of 50 cc or larger reported that they
strained more to void than men with smaller prostate glands (P = .04).
"A possible explanation is that larger glands on average received higher
doses of radiation than smaller glands," Dr. Stone said.
He stressed that the overall differences in long-term urinary
or quality-of-life complaints were not substantial. "Patients with small
or large prostates should be considered good candidates for permanent prostate
brachytherapy," Dr. Stone said.
The only other significant differences between pretreatment and
post-treatment scores were a slight increase in intermittency in the patients
with the smallest prostates (less than 25
cc in volume) and an increase in urgency in those with moderate size prostates
(25 cc to 50 cc), the researchers reported.