IRIDIUM-192 HIGH-DOSE-RATE BRACHYTHERAPY - A USEFUL ALTERNATIVE THERAPY FOR LOCALIZED PROSTATE-CANCER

We report on a novel protocol involving iridium 192 high-dose-rate bra chytherapy and follow-up of up to 130 months in patients with prostati c carcinoma. Using regional anesthesia, five to seven hollow needles a re placed within the prostate by perineal puncture under ultrasound gu idance. A 9-Gy prostate dose is applied followed by 30 min of hyperthe rmia (since 1991). This treatment is repeated once after 7 days; 2 wee ks later, 18 x 2-Gy external beam radiation (small-field prostate) is added as percutaneous dose saturation. Since 1984 we have treated 40 p atients with this protocol. Local tumor control was achieved by means of prostatic biopsy at 18 months after therapy and determination of pr ostate-specific antigen (PSA) values in about 70% of the patients; aft er a mean follow-up period of more than 6 years (16-130 months), 80% o f the patients show either no evidence of disease or stable disease. W e therefore conclude that iridium 192 high-dose-rate brachytherapy is a useful alternative in the treatment of localized prostate cancer in patients who are not eligible for radical prostatectomy.