Transperineal interstitial implantation of prostate cancer: A new method

Abstract

A method of transperineal interstitial implant of prostate without the need for surgical exploration was used to provide a boost dose of 3200 rad to the implanted volume in patients with relatively advanced Stage C carcinoma of the prostate. All patients were initially givern megavoltage teletherapy to a dose of 4320 rad in 24 treatments via anteroposterior and posteroanterior en bloc pelvic and para-aortic portals; then, lateral pelvic ports were used to give additional 1400 rad in 7 treatments. The implant was performed three to four weeks later. Twenty-three patients were treated since 1971; the follow-up period was a minimum of two years in all except three patients. Fifteen patients were alive disease-free; one died of ulcerative colitis, disease-free at 28 months and one was alive with disease at this writing. Disease was locally controlled among all patients except one (96%). The morbitity was insignificant and the quality of life was good. The time of recurrence was from three to nine months in the seven patients who failed., Six of these died before 30 months; three had poorly differentiated histology. No patient among those initially diagnosed by needle biopsy had failed whereas 50% of those whose diagnosis was by transurethral resection showed distant metastases; only one of these patients had concurrent local failure.