Outcomes of Prostate Cancer Patients after Brachytherapy

  Objective  To evaluate the effectiveness and complications of prostate brachytherapy.

  Methods  We enrolled 27 prostate cancer patients aged 63 to 81 years(mean:75 years)in our study, with 16 at the clinical stage of T1cN0M0, 11 at T2aN0M0, and 14 with Gleason score of 5, 13 with Gleason score of 6. Their serum prostate specific antigen(PSA)levels ranged 2.8-18.6 μg/L(mean:8.5 μg/L). All of them underwent ¹²⁵I seed implantation with the D90 of 140-155 Gy and had the serum PSA levels routinely determined after the procedure.Effectiveness and complications were also observed. None of the 27 patients were treated with hormone therapy.

  Results  Follow-up ranged from 12 to 74 months(mean:44 months). The median nadir PSA was 0.18 μg/L, with only 2 above 1.0 μg/L. One year after brachytherapy, the median level of serum PSA was 0.71 μg/L(mean:0.92 μg/L), and 17 with the level under 1.0 μg/L. Two patients(7%)experienced biochemical failure at the 30 month and 48 month after the procedure. Two patients(7%)developed acute urinary retention, which was released after catheterization for 1 week. Low urinary tract symptoms were observed in 24 patients, which were improved 6-12 months later. No prostate-rectal fistula was observed. Seventeen patients erected efficiently before brachytherapy, while 10 preserved erection in different levels after brachytherapy. The incidence of erectile dysfunction was 41%(7/17).

  Conclusion  Prostate brachytherapy is an effective treatment for low- and intermediate-risk patients with acceptable complications. Most patients can preserve sexual function after this procedure.