PROSTATE BRACHYTHERAPY IN PATIENTS WITH INFLAMMATORY BOWEL-DISEASE

Purpose: There are minimal data to support the perceived contraindicat ion of radiation therapy in patients with inflammatory bowel disease ( IBD). Because of widespread concern about the possibility of radiation -related morbidity in IBD patients, the posttreatment course for 6 pat ients with a history of LED who were treated with I-125 prostate impla ntation for early stage prostate cancer are reported here. Materials a nd Methods: Six patients with a prior history of IBD and Stage T1c-T2c prostatic carcinoma underwent I-125 prostate brachytherapy from 1991- 1996. Three patients had Crohn's disease and three had ulcerative coli tis. The treatment plans were designed to treat the preimplant prostat ic margin, as defined on planning CT scan, to 150 Gy. No special effor t was made to minimize the rectal surface dose. Detailed records were available for all patients, and all patients were interviewed for this report, Follow-up ranged from 1 to 6 years (median: 3.7 years). Resul ts: None of the 6 patients experienced unusual or significant gastroin testinal side effects following implantation. All 6 patients remain fr ee of GI complications. The rectal surface area that received > 100 Gy was kept below 10 mm(2) in all patients, in accordance with previousl y published guidelines, Conclusions: Based on the limited information available, it appears that prostate brachytherapy is safe in patients with a history of LED. (C) 1998 Elsevier Science Inc.