%A"Beyer, David C" %A"Priestley, Joseph B" %D1995 %I; %2 %J[] %K62 RADIOLOGY AND NUCLEAR MEDICINE, CARCINOMAS, IODINE 125, MULTIVARIATE ANALYSIS, PROSTATE, RADIATION SOURCE IMPLANTS, RADIOTHERAPY, SIDE EFFECTS, SURGERY, SURVIVAL CURVES, ULTRASONOGRAPHY %PMedium: X; Size: page(s) 254 %TBiochemical disease-free survival following I-125 prostate implantation %XPurpose/Objective: To assess the five-year clinical and biochemical results of ultrasound-guided permanent I-125 brachytherapy in early prostate cancer. Biochemical disease-free survival (BDFS) is reported, using PSA follow-up and is compared to the surgical and radiation therapy literature. Materials and Methods: From 12/88 through 12/93, ultrasound-guided brachytherapy was preplanned with I-125 and delivered 16,000 cGy as the sole treatment in 499 patients. All were clinically staged as T1 or T2 - N0M0 adenocarcinoma of the prostate. Within the first year, 19 patients were lost to follow-up and have been excluded from further study. The remaining 480 patients form the basis of this report. Clinical status and PSA values were systematically recorded before and after treatment. Results: With a median follow-up of 35 months (3-70) the actuarial clinical local control is 83%. Both stage and grade are shown to predict for this endpoint. Actuarial BDFS is also correlated with stage, grade, and PSA at presentation. Biochemical disease-free survival at five years is 94% for T1, 70% for unilateral T2, and 34% for T2c tumors. Grade is also predictive, ranging from 85% in low-grade tumors to 30% in high-grade tumors. In a multivariate analysis, the pretreatment PSA is most highly correlated (p < 0.0001). Patients with a normal pretreatment PSA enjoyed 93% BDFS, while those presenting with PSA > 10 had a BDFS of 40%. Complications have been few, with severe urinary urgency or dysuria in 4% and both incontinence and proctitis seen in 1%. Conclusion: While biochemical disease-free survival reports in the literature are immature and have short follow-up, our data compares favorably with studies following radical prostatectomy or radiation therapy. Further follow-up of this cohort is required. The complication rate is low and patient acceptance excellent. Permanent implantation of I-125 as the sole treatment for early prostate cancer is a viable alternative for patients with early stage and low- to moderate-grade cancers. The PSA provides significant prognostic information and aids in case selection. Better management options are needed for high-grade and bilateral tumors. %0Journal Article %N;Journal ID: ISSN 0360-3016; IOBPD3; TRN: US03R1979005143 %1 %CUnited States %Rhttps://doi.org/10.1016/0360-3016(95)97887-7 Journal ID: ISSN 0360-3016; IOBPD3; TRN: US03R1979005143 INIS %GEnglish