Combined treatment with temporary short-term high dose rate iridium-192
brachytherapy and external beam radiotherapy for irradiation of localized
prostatic carcinoma.

Radiother Oncol 1997;44(3):237-44

Borghede G; Hedelin H; Holmang S; Johansson KA; Aldenborg F; Pettersson
S; Sernbo G; Wallgren A; Mercke C
AD - Department of Oncology, Sahlgrenska University Hospital, Goteborg
University, Sweden.
AB - PURPOSE: To evaluate the treatment outcome after radical radiotherapy
of localized prostate cancer in 50 patients (38 patients with stage
T1-2 and 12 patients with stage T3) after a median follow-up time of
45 months (range 18-92 months). METHODS: The treatment was given by
combination of external beam radiotherapy (50 Gy) and brachytherapy
(2 x 10 Gy). The brachytherapy was given using TRUS-guided percutane-
ously inserted temporary needles with a high dose rate remote
afterloading technique with Ir-192 as the radionuclide source. Three
target definitions and dose levels inside the prostate gland were
used. Local control was evaluated by digital rectal examination,
TRUS-guided biopsies and serum PSA evaluations. RESULTS: Clinical and
biopsy verified local control was achieved in 48 of the 50 (96%)
patients; for stage T1-2 in 37 of 38 (97%) patients and for stage T3
in 11 of 12 (92%) patients. A posttreatment serum PSA level < or =1.0
ng/ml was seen in 42 (84%) patients, values from >1.0 to < or =2.0
ng/ml were seen in four (8%) patients and values exceeding 2.0 were
seen in four (8%) patients. The late toxicity was minimal. CONCLUSIO-
N: The local control results and the minimal toxicity after the
combined radiotherapy treatment are promising. However, long term
results are necessary before general use.