Prostate Brachytherapy in Patients with Inflammatory Bowel Disease

Abstract

Purpose: There are minimal data to support the perceived contraindication of radiation therapy in patients with inflammatory bowel disease (IBD). Because of widespread concern about the possibility of radiation-related morbidity in IBD patients, the posttreatment course for 6 patients with a history of IBD who were treated with 125I prostate implantation for early stage prostate cancer are reported here. Materials and Methods: Six patients with a prior history of IBD and Stage T1c–T2c prostatic carcinoma underwent 125I prostate brachytherapy from 1991–1996. Three patients had Crohn’s disease and three had ulcerative colitis. The treatment plans were designed to treat the preimplant prostatic margin, as defined on planning CT scan, to 150 Gy. No special effort was made to minimize the rectal surface dose. Detailed records were available for all patients, and all patients were interviewed for this report. Follow-up ranged from 1 to 6 years (median: 3.7 years). Results: None of the 6 patients experienced unusual or significant gastrointestinal side effects following implantation. All 6 patients remain free of GI complications. The rectal surface area that received >100 Gy was kept below 10 mm 2 in all patients, in accordance with previously published guidelines. Conclusions: Based on the limited information available, it appears that prostate brachytherapy is safe in patients with a history of IBD.