Abstract
The therapeutic options for patients with locally recurrent adenocarcinoma of prostate following initial radiotherapy are limited. This study evaluated the efficacy and safety of permanent gold-198 implant alone in patients who had failed prior radiotherapy. Between 1990 and 1996, a total of 30 patients with locally recurrent prostate cancer were treated with permanent transperineal 198Au implant alone. Mean dose to the whole gland was 20 Gy, with a mean activity of 64.8 mCi. Mean follow, up was 4.1 years. Five of the 30 patients showed control of disease progression. The other 25 patients who failed had a rising prostate-specific antigen (PSA) level on at least three consecutive measurements. Pretreatment PSA level was the only significant prognostic factor, with a mean of 1.46 ng/mL in the disease- controlled group compared with 12.4 ng/mL in the failed group (P<.01). The majority of the treatment-related lower gastrointestinal and genitourinary toxicities were transient, and no grade 3 or above toxicities were observed. This is the first report to use PSA level as a predictor for local control of tumor recurrence following brachytherapy. Prostate-specific antigen level at the time of recurrence appears to be an important factor in the ultimate control of the disease. Gold-198 brachytherapy appears to be feasible and safe in appropriately selected patients with low PSA levels. Future strategies should include dose escalation and combined hormonal therapy.
Original language | English (US) |
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Pages (from-to) | 233-240 |
Number of pages | 8 |
Journal | Journal of Brachytherapy International |
Volume | 14 |
Issue number | 4 |
State | Published - 1998 |
Keywords
- Brachytherapy
- Gold-198 implant
- Recurrent prostate cancer
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cancer Research