Permanent gold-198 implant for locally recurrent adenocarcinoma of the prostate after failing initial radiotherapy

Bin S. Teh, B. M. Berner, L. S. Carpenter, J. K. Chiu, W. S. Dennis, H. H. Lu, S. Y. Woo, Edward Brian Butler

Research output: Contribution to journalArticle

4 Scopus citations

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 languageEnglish (US)
Pages (from-to)233-240
Number of pages8
JournalJournal of Brachytherapy International
Volume14
Issue number4
StatePublished - 1998

Keywords

  • Brachytherapy
  • Gold-198 implant
  • Recurrent prostate cancer

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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