A study that evaluated 76 patients, aged 48 to 62 years, who underwent prostate brachytherapy between 1995 and 1999 using either palladium-103 or iodine-125 seed implants, reported that more than 98% achieved 5-year survival. The study report was published in a recent issue of the International Journal of Radiation Oncology, Biology, and Physics (50:1253-1257, 2001).
"This study reinforces the notion that brachytherapy is often the optimal treatment for early-stage prostate cancer in men under 65," said researcher Gregory Merrick, MD, of the Schiffler Cancer Center in Wheeling, WV. "These are encouraging findings because it shows younger men that they can survive cancer with a significantly lower incidence of side effects." Common side effects associated with prostate cancer treatment are incontinence and erectile dysfunction.
All 76 patients underwent transperineal ultrasound-guided prostate brachytherapy; 47 patients received only brachytherapy, and 29 received moderate-dose external-beam radiation followed by brachytherapy. None of the patients received hormonal manipulation as part of their treatment.
Patients were stratified according to disease level as determined by clinical T stage, prostate-specific antigen (PSA) level, and Gleason score. Low-risk disease was defined as exhibiting all three favorable prognostic indicators, intermediate-risk disease as exhibiting one unfavorable indicator, and high-risk disease as exhibiting two or more unfavorable indicators.
After treatment, patients were screened every 3 to 6 months for disease recurrence with digital rectal examinations and PSA tests. Among patients with low-, medium-, and high-risk disease, 97.7%, 100%, and 100%, respectively, experienced biochemical freedom from failure 37 months after treatment. Of the entire group, 98.7% showed no evidence of disease at 37-month follow-up.
Effect of Age on Brachytherapy Outcomes