Comparison of Two Treatment Approaches for Prostate Cancer: Combined Intensity Modulated Radiation Therapy with 125I Seed Implant Brachytherapy and 125I Seed Implant Brachytherapy alone

Abstract

The purpose of this study was to assess the results of two different treatment approaches for clinically localized prostate cancer: intensity modulated radiation therapy (IMRT) followed by ¹²⁵Iodine (¹²⁵I) seed implant brachytherapy and ¹²⁵I seed implant brachytherapy alone. Thirty most recent consecutive patients were studied. The sample population consisted of 15 cases treated with IMRT (50.4 Gy), followed by ¹²⁵I seed implant boost (95 Gy), and 15 cases treated with ¹²⁵I seed implant only (144 Gy). Established dosimetric indices and various clinical parameters were analyzed. In addition, the acute urinary morbidities of the two treatment approaches, as assessed by the International Prostate Symptom Score (IPSS), were also evaluated and compared. In our series, IMRT followed by ¹²⁵I seed implant brachytherapy slightly increased the acute urinary morbidity compared with ¹²⁵I seed implant brachytherapy alone. In addition, there was no statistically significant correlation between the IPSS and the maximum or mean urethral dose. Combination of IMRT and seed implant brachytherapy presents an alternative opportunity to treat clinically localized prostate cancer. Its full potential needs to be further investigated.