Long Term Outcomes of Permanent I-125 Prostate Seed Implant for Early Prostate Cancer

Long Term Outcomes of Permanent I-125 Prostate Seed Implant for Early Prostate Cancer
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Title:Long Term Outcomes of Permanent I-125 Prostate Seed Implant for Early Prostate Cancer
Author/Abstract:

Sigfred Ian R. Alpajaro, MD and Jason L. Letran, MD, FPUA
Section of Urology, Department of Surgery, University of Sto. Tomas Hospital

Objective: Since its introduction in the Philippines in 2001, low dose rate brachytherapy (permanent I-125 prostate seed implant) has
become one of the widely utilized modality for the treatment of localized prostate cancer. This study aimed to evaluate the long-term
clinical outcomes of low dose rate prostate brachytherapy (Permanent I-125 Prostate Seed Implant) in terms of overall survival (OS),
disease specific survival (DSS), biochemical no evidence of disease (BNED), complications and mortality.

Materials and Methods: Two hundred and two consecutive patients who underwent permanent I-125 prostate seed implant from April 2002 to
December 2012 were included in this study. The details of all patients were derived from the database of a single urologist. The median
follow up is 6.3 years. Kaplan-Meier curves were used to evaluate overall survival, prostate cancer specific survival and biochemical no
evidence of disease (defined by the ASTRO criteria) across all disease risks. Treatmentrelated complications and causes of mortality were
also reviewed.

Results: The 11-year overall survival and disease-specific survival rates were 89.1% and 98%, respectively. The biochemical no evidence of
disease was 82.7%. Log rank testing showed that survival in terms of OS, DSS, and BNED did not differ significantly regardless of risk
stratification into low, moderate and high risk groups. The treatment-related morbidity rate for this series was 5.4%.
Conclusion: Brachytherapy is an effective treatment for localized prostate cancer with favorable long term survival results, durable
biochemical outcomes, and minimal toxicity.

Key words: prostate cancer, brachytherapy, prostate seed implant, biochemical no evidence of disease, survival

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