Monobrachytherapy for prostate cancer

Here we use the principle of hypofractionation (few but high doses placed with high precision) using a high quality dosimetry system. The method corresponds to permanent implantation of radioactive seeds (I-125), but leaves no radioactive metal seeds in the body.

Indications

Early prostate cancer, stage T1-T2, PSA < 10, Gleason score < 7, prostate volume < 50 cm3.

The patient should not be taking anticoagulants, and there should be no contraindications to spinal anesthesia.

Dose

Patients aged <66: 11 Gy, 3 times at 2-week intervals; in-patient time = 1 day per treatment.

Patients aged ≥66: 14 Gy, twice with a 2-week interval, in-patient time = 1 day per treatment.

Patients are given a total of 6 doses of antibiotics (Ciprofloxacin 500 mg), starting the evening before surgery. A small enema is given the evening before surgery and again just before surgery. Admission takes place in the morning, and after lunch spinal anesthesia is started and applicators are placed in a gynecological position. A Foley catheter is placed overnight, and the patient can be discharged the next morning.

At the end of the treatment series the patients will experience urethritis.

Waiting time for treatment is 1-3 months.

Long-term documentation (over 5 years’ follow-up) of this treatment   method is not available.


Page revised Tuesday, April 5, 2011

Published by Anita Pettersson