The Efficacy Of Brachytherapy On The Patients With Clinically Localized Intermediate And High-risk Prostate Cancer

Background and Objectives With a high level of morbidity and mortality,prostate cancer has been one of the most common malignant neoplasms in the U.S. and the Europe.There is an increased tendency for prostate cancer in China, in spite of a relatively low incidence compared with that of the U.S. and the Europe.Being advantageous in invasiveness,postoperative recovery,complications and sexual function, brachytherapy has evolved rapidly in the past 10 years.The efficacy of brachytherapy on the patients with low-risk shows satisfactory,remains controversial for intermediate and clinically localized high-risk patients. Since few literature was concerned with the exclusive application of brachytherapy on intermediate and clinically localized high-risk groups, its theraputic significance was then discussed.Materials and Methods A total of 31 prostate cancer patients were enrolled for brachytherapy from 2009.2 to 2010.3 in Sir Run Run Shaw Hospital,and categorized into low-risk group(5cases),intermediate-risk group(5cases)and high-risk group (21 cases) respectively,according to clinic stage, PSA and Gleason score. Transrectal ultrasonographic images were collected and transfered to the computer treatment planning system for 3D reconstruction and the proposed implantation targets, with modulations of radiation dose adjacent to the urethra and the rectum.Seeds were then released transperineally by the distributor through navigating template. Radiographic images on Dayl postoperative were compared with those obtained on Day28 to discover possible seeds migration. And monitored of PSA monthly within one year.Results All the procedures were uneventful,with a range of 26 to 139 radioactive seeds implanted(mean 53.5) during 50-110 min(mean 67 min).All patients were followed up for 1-13months(median duration 7months). Hundred percent of intermediate group'postoperative PSA decreased over 50%. A significant decrease of PSA(by mean 71.0%) was appriciated in HRCLPC group postoperatively, based on the lastest follow-up data.And 83.3%(15/18)of the patients'postoperative PSA decreased over 50%.Conclusions The efficacy of intermediate group shows satisfactory.Short term follow-up shows satisfactory results in HRCLPC treated with brachytherapy in terms of PSA.