Palladium-103 brachytherapy for prostate carcinoma

Int J Radiat Oncol Biol Phys. 2000 Mar 1;46(4):839-50. doi: 10.1016/s0360-3016(99)00499-x.

Abstract

Purpose: A report of biochemical outcomes for patients treated with palladium-103 (Pd-103) brachytherapy over a fixed time interval.

Methods and materials: Two hundred thirty patients with clinical stage T1-T2 prostate cancer were treated with Pd-103 brachytherapy and followed with prostate-specific antigen (PSA) determinations. Kaplan-Meier estimates of biochemical failure on the basis of two consecutive elevations of PSA were utilized. Multivariate risk groups were constructed. Aggregate PSA response by time interval was assessed.

Results: The overall biochemical control rate achieved at 9 years was 83.5%. Failures were local 3.0%; distant 6.1%; PSA progression only 4.3%. Significant risk factors contributing to failure were serum PSA greater than 10 ng/ml and Gleason sum of 7 or greater. Five-year biochemical control for those exhibiting neither risk factor was 94%; one risk factor, 82%; both risk factors, 65%. When all 1354 PSA determinations obtained for this cohort were considered, the patients with a proportion of PSAs < or = 0.5 ng/ml continued to increase until at least 48 months post-therapy. These data conformed to a median PSA half-life of 96.2 days.

Conclusions: Prostate brachytherapy with Pd-103 achieves a high rate of biochemical and clinical control in patients with clinically organ-confined disease. PSA response following brachytherapy with low-dose-rate isotopes is protracted.

MeSH terms

  • Aged
  • Analysis of Variance
  • Brachytherapy / methods*
  • Cohort Studies
  • Disease-Free Survival
  • Follow-Up Studies
  • Half-Life
  • Humans
  • Male
  • Neoplasm Staging
  • Palladium / therapeutic use*
  • Prospective Studies
  • Prostate-Specific Antigen / blood*
  • Prostatic Neoplasms / blood*
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / radiotherapy*
  • Radioisotopes / therapeutic use*
  • Radiopharmaceuticals / therapeutic use*
  • Treatment Failure
  • Ultrasonography, Interventional

Substances

  • Radioisotopes
  • Radiopharmaceuticals
  • Palladium
  • Prostate-Specific Antigen