Interstitial radiotherapy "1-125 Rapid-Strand" of local prostatic cancer

Аннотация

Nikolai Alekseevich Lopatkin, Academician of the Russian Academy
of Medical Sciences, has contributed much to development of
prostatic cancer (PC) diagnosis and treatment in the Russian Federation.
N. A. Lopatkin headed specialists from the Research Institute
of Urology who were the first in Russia to introduce into clinical practice
the method of interstitial radiotherapy (brachitherapy) of local
prostatic cancer (PC). A total of 58 PC patients 42 to 76 years of age
were treated. They had stages TlbNOMO (n = 5), T2aN0M0 (n =36),
T2bN0M0 (n = 11), T3aN0M0 (n = 6). Staging was made by
the'data of finger rectal examination, transrectal ultrasonography,
NMR tomography, radionuclide osteoscintigraphy. Mean PSA was
2.5-36 ng/ml in the size of the prostatic gland 14.96-52.76 cm3. All
the patients received neoadjuvant hormone therapy. Four patients one
year or more before the radiotherapy had TUR of the prostate. Brachitherapy
was made under peridural anesthesia which allowed implantation
of 40-120 sourses with activity of 0.38-0.35 mCi for 20-45
min. A total dose was 120-160 Gy. Mean hospital stay was 4 days.
Spontaneous urination recovered within 6 postoperative hours. The
procedure was well tolerated, complications arose on postimplantation
day 2-8. We attribute complications to inadequate calculation of
the doses at the stage of the method introduction. A short follow-up
(3 years) is not long enough to allow conclusions about the efficacy
of the method. Within 3 years biochemical recurrence occurred in 4
(6.9%) patients on months 14-26 (stage T2b and 2-T3). Four patients
were lost for follow-up. Thus, brachitherapy efficacy depended much
on adequite selection of the patients and planning of the procedure
by the results of previous volumetry. The procedure is safe and reproducible.
The studies will be continued.