Role of transrectal ultrasonography in prostatic brachytherapy
Ippolito, C.; Spisani, L.; De Luca, G.; Romano, A.; Daniele, C.; Cartei, F.; Lavagnini, P.; Princivalle, S.; Lappi, S.
Archivio Italiano di Urologia Andrologia Organo Ufficiale di Societa Italiana di Ecografia Urologica e Nefrologica 74(4): 295-298
2002
ISSN/ISBN: 1124-3562 PMID: 12508756 Document Number: 545249
The rationale for interstitial brachytherapy (seed implant) is based on the principle that dissipation of radiation energy in tissues decreases exponentially as the square of source would receive maximal doses of radiation, there will be a rapid fall-off the dose in surrounding normal tissues. Over the years, a range of isotopes have been tested, and the technique have evolved from free-hand implantation to ultrasound guided template system. From September 2001 to March 2002 we treated 17 patients with clinically localized prostatic cancer. For seed implantation we used the transrectal ultrasound guided implantation of 125I source. Isodose distributions are provided at each 5 mm increment throughout the treatment volume to determine the precise localization of seed placement. 23.5% of patients developed acute urinary retention, 11.8% incidence of transurethral resection after 6 months and 0% incidence of urinary incontinence. Longer follow-up will be necessary for biochemical failure. Permanent interstitial implantation should be limited to patients with early stage disease with favourable prognostic features. The use of transrectal ultrasound as diagnostic system as guided implantation is the most popular approach even in experienced hands.