LONG-TERM RESULTS OF COMBINED INTERSTITIAL GOLD SEED IMPLANTATION PLUS EXTERNAL-BEAM IRRADIATION IN LOCALIZED CARCINOMA OF THE PROSTATE

Carcinoma of the prostate is one of the leading causes of death in men . Patients with localised disease can be treated with radiotherapy, bu t controversy still exists regarding the most effective therapeutic te chnique. We report 180 patients with surgical stage A2-C prostate canc er treated between 1976 and 1986 by pelvic lymphadenectomy and radioac tive gold seed implantation followed by external irradiation. Annual p ost-treatment biopsies were performed up to 5 years in most patients. Regular follow-up included a digital rectal examination, prostatic aci d phosphatase and bone scan. One hundred and sixty-four patients had c omplete follow-up data at the end-point of data collection (December 1 991). The actuarial 10-year cancer-free survival rates were 83.0% and 91.3% for stages A2 and B1 respectively. The incidence of positive bio psy at 2 and 5 years was 13% and 17.1% respectively for the whole seri es. A firm correlation was defined between biopsy result and subsequen t development of local progression, distant metastases and overall sur vival. Combined interstitial gold seed implantation plus external beam irradiation represent a valid option for the treatment of patients wi th localised prostatic cancer.