The Baylor College of Medicine experience with gold seed implantation

Edward Brian Butler, Peter T. Scardino, Bin S. Teh, Barry M. Uhl, W. Graham Guerriero, C. Eugene Carlton, Barry M. Berner, W. Sam Dennis, L. Steven Carpenter, Hsin H. Lu, J. Kam Chiu, T. Spencer Kent, Shiao Y. Woo

Research output: Contribution to journalArticlepeer-review

30 Scopus citations

Abstract

Advances in imaging technology and implant technique have led to the resurgent interest and practice of brachytherapy for the treatment of prostate cancer. Brachytherapy is a form of radiation treatment in which radioactive sources are placed directly into the tumor; it offers the advantage of maximizing the radiation dose delivered to the tumor while sparing the adjacent normal tissue. Permanent implants have become an important component of radiation delivery. Interstitial gold radioisotope (Au- 198) implants for prostate cancer were introduced at Baylor College of Medicine in 1965. The rationale for using Au-198, instead of the two most commonly used radioisotopes, Palladium- 103 (Pd- 103) and Iodine- 125 (I- 125), is discussed, and the Baylor implant technique is compared to that used in other centers. Retrospective review divides the patient population into pre-ultrasound versus post-ultrasound eras. Dosimetric calculation and disease control with the Au-198 seed implant for prostatic cancer are reviewed for the two different eras; toxicity is evaluated in the post- ultrasound era only. In the pre-ultrasound era, 510 patients were treated with pelvic lymph node sampling and gold seed insertion of the prostate followed by external beam radiation. In the post-ultrasound era, 54 patients were treated definitively with ultrasound-guided transperineal Au-198 implant followed by external beam irradiation. A small group of 30 patients in the post-ultrasound era were evaluated for the efficacy of Au-198 re- implantation for locally recurrent disease.

Original languageEnglish (US)
Pages (from-to)406-418
Number of pages13
JournalSeminars in Surgical Oncology
Volume13
Issue number6
DOIs
StatePublished - Nov 1997

Keywords

  • Brachytherapy
  • Gold radioisotopes
  • Interventional ultrasonography
  • Iodine radioisotopes
  • Palladium isotopes
  • Prostatic neoplasms
  • Radiotherapy

ASJC Scopus subject areas

  • Surgery
  • Oncology

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