Eight years experience of local prostate cancer treatment with permanent I125 seed brachytherapy--morbidity and outcome results

Abstract

Background and purpose: There are only a limited number of reports of treatment of prostate cancer with permanent prostate seed I(125) brachytherapy (PPB) in Europe. We describe results from one Finnish institution having treated 444 patients with a follow-up of eight years.

Material and methods: Morbidity was evaluated by International Prostate Symptom Score and International Index of Erectile Function questionnaires. Urine flow, residual urine volume and the PSA values were measured pre-treatment and during follow-up. Any additional treatments were recorded.

Results: PPB was well tolerated. Median IPSS increased from 8 at baseline to 18 at three months post-therapy and returned to baseline score within 12 months. Median urine flow decreased from 15.2 ml/s at baseline to 10.2 ml/s at three months and returned to baseline value within two years. Acute urinary retention, potency preservation and severe proctitis were observed in 11%, 86% and 2% of patients, respectively. The PSA bounce was observed in 13% and PSA nadir < or =0.5 microg/l was reached by 81% of patients. Disease-free survival (DFS) was 90.2%. In the Cox regression analysis, the independent predictors of DFS were risk group and PSA nadir < or =0.5 microg/l (p<0.0001 for both). PC-specific survival was 98.5% and overall survival was 94.6%.

Conclusions: Our results are in concordance and comparable with other reports on PPB.