Side effects of permanent I125 prostate seed implants in 667 patients treated in Leeds

• Published in: Radiotherapy and oncology 2007-01, Vol.82 (1), p.46-49
• Main Authors: Bottomley, David, Ash, Dan, Al-Qaisieh, Bashar, Carey, Brendan, Joseph, Joji, St Clair, Shaun, Gould, Kathy
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Brachytherapy - methods; Erectile Dysfunction - epidemiology; Erectile Dysfunction - etiology; Hematology, Oncology and Palliative Medicine; Humans; Iodine Radioisotopes - adverse effects; Iodine Radioisotopes - therapeutic use; Logistic Models; Male; Morbidity; Prostate brachytherapy; Prostatic Neoplasms - radiotherapy; Radiation toxicity; Radiotherapy Dosage; Risk; Urethritis - epidemiology; Urethritis - etiology; Urinary Incontinence - epidemiology; Urinary Incontinence - etiology; Urinary Retention - epidemiology; Urinary Retention - etiology
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/j.radonc.2006.11.006

Abstract Purpose To report the side effects and complications after I-125 seeds prostate implant after 8.5 years experience. Methods and materials Six hundred and sixty seven (667) patients were treated between March 1995 and December 2001. The median follow up is 31 months with a maximum of 98.2 months. Morbidity data were collected from a review of patient case-notes. Patients also provided prospective data on urinary symptoms using the International Prostate Symptom Score (IPSS) scoring chart before treatment and at regular follow up. Patients were also sent a questionnaire detailing symptoms and side effects following their brachytherapy. This enabled them to record urinary, bowel and sexual function side effects independently. Logistic regression analysis was carried out to identify the risk of catheterisation in relation to the pre-implant prostate volume and potential implant factors such as the number of seeds and needles and implant dose. Result The urinary symptom score rises in the first few months after implantation and returns to within one or two points of the pre-treatment score within one year. Nine patients reported incontinence prior to treatment and 15, 12 and 10 patients reported incontinence 6, 12 and 24 months after treatment, respectively. Catheterisation was reported in 97 (14.5%) patients. At six months 84.9% of patients reported no change in bowel function and 78.9% at 12 months. 6.4% of patients complained of some increased bowel frequency at 6 months and 5.7% at 12 months. 402 (77.2%) patients reported being fully potent before treatment and that this fell to 32.4% after treatment. Logistic regression showed that the most significant factors which correlate with the probability of catheterisation are the pre-treatment prostate volume and the number of seeds and needles implanted. Conclusion The side effects and complications after prostate brachytherapy as reported here and elsewhere confirm that the treatment is not only convenient but also has a low risk of serious long term side effects.