Minimally invasive treatment for localized adenocarcinoma of the prostate : Review of 1048 patients treated with ultrasound-guided palladium-103 brachytherapy

ABSTRACT Purpose: To assess the effectiveness of palladium-103 brachytherapy in stage T1 and T2 adenocarcinoma of the prostate. Patients and Methods: The charts of 1048 patients treated between 1991 and 1999 with transperineal realtime ultrasound-guided 103Pd (Theraseed®) implants were reviewed to assess the effects on serum prostate specific antigen (PSA) values and tissue (biopsy). Of the 1048 patients, 780 had sufficient data for this report. Preoperative total androgen blockade (leuprolide and flutamide) was used selectively in patients whose prostate size was >50 cc and those whose tumors had a Gleason score of >7. Results: At 1 year, 86% of the evaluable 766 patients had stable PSA concentration <1.5 ng/mL; at 5 years, 86% of the 166 patients with data available had stable PSA values <1.5 ng/mL. Biopsies were negative in 92% of the patients studied at 2 years. Patients with pretreatment PSA values <10 ng/mL had the best outcomes, and those treated with 103Pd plus hormone ablation achieved PSA reduct...