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Brachytherapy Effectively Treats Prostate Cancer

Prostate brachytherapy with Cesium-131 places cancer-fighting medical radioisotopes in and/or around the prostate, as close to the cancer as possible.  The isotopes are encased in capsules the size of a grain of rice and release a personalized radiation dose over a period of days. This allows the effective treatment of the prostate while minimizing side effects and damage to nearby tissue.

A comprehensive review of the literature comparing risk stratified patients by treatment with long-term follow-up, Grimm et al, provided a visual comparison of different treatments for prostate cancer.

Low Risk

Low Risk - Prostate Brachytherapy

High Risk

High Risk

Patients undergoing prostate brachytherapy with 131Cs have excellent oncological outcomes at 5 years. Although more years of follow-up are required to assess the true cancer control ability of prostate brachytherapy with 131Cs, these intermediate-term outcomes show that there is no reason at this time to suspect that 131Cs will not provide oncological outcomes at least on par with those of 125I and 103Pd.

Ron Benoit, MD

Prostate brachytherapy with Cesium-131 has a growing base of clinical experience.  This study, from Benoit (1) followed 485 patients of different risk groups treated with Cesium 131 to measure if the disease progressed.  At five years, 96% of men with low risk disease, 92.7 of men with intermediate risk disease and 82.9% of men with high risk disease showed no evidence of disease progression.

Quality of Life

The short half life of Cesium-131 delivers treatment quickly to the patient, and allows the patient to recover quickly. As seen below, studies have shown that the patient IPSS will return to baseline faster than following brachytherapy with either Iodine and Palladium. This gives patients the opportunity to put treatment behind them, and move beyond their cancer.

Quality of Life post Prostate Brachytherapy

Need for Alternative Treatments

With changing healthcare dynamics, clinicians are continually looking for new alternatives for patients with challenging cancers. Brachytherapy with Cesium-131 can provide that alternative:

Targeted Treatments in Prostate Brachytherapy
  • In patients with prior radiation treatment for their prostate cancer, the concentrated energy delivery of Cesium-131 may allow additional radiation to treatment residual disease.
  • In patients with low volume, low risk disease, Cesium-131 may provide an alternative as a Targeted treatment option, providing a demonstrated therapeutic option with a limited risk of side-effects.

Overall Benefit of Brachytherapy

Many factors contribute to a treatment’s overall “effectiveness”. In addition to being highly effective in treating different forms of cancer, brachytherapy is a fraction of the total cost to the healthcare system when compared to other popular treatments.

Isoray_Spider
Re-purposed from the International Consortium for Health Outcomes Measurement; MD Anderson Cancer Center via HBR.org.

What You Should Know About Prostate Cancer

Download our PDF for Information about Prostate Cancer and Patient Screening

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Resources

1. Benoit, et al., “Five Year Prostate Specific Antigen Outcomes after Cesium Brachytherapy”, Clin Onc, 26 (2014) 776-780.

2. Grimm, et al., “Comparative analysis of prostate-specific antigen free survival outcomes for patients with low, intermediate and high risk prostate cancer treatment by radical therapyBJUI, 109S1, 2012 p 22-29.

3. ArmpillaC, Dale R, Coles I, et al. The determination of radiobiologically optimized half-lives for radionuclides used in permanent brachytherapy implants. Int J Rad Onc Bio Phys 2003; 55:378-385.

4. Shah AB, et al. A Comparison of AUA Symptom Scores following Permanent Low-Dose-Rate Prostate Brachytherapy with Iodine-125 and Cesium-131.

5. Bice, W. “Permanent prostate brachytherapy using Cs-131 for localized prostatic carcinoma: a phase II study.” Presented at the 2008 Cesium Advisory Group Meeting November 2008. Tuscon, Arizona, U.S.A.

6. Keyes M, et al. “Predictive factors for acute and late urinary toxicity after permanent prostate brachytherapy: long-term outcomes in 712 consecutive patients.” International Journal of Radiation Oncology, Biology and Physics 73(4):1023-32, 2009.

7. Ash D, et al. “A prospective analysis of long-term quality of life after permanent I-125 brachytherapy for localized prostate cancer.” Radiotherapy and Oncology 84(2):145-9, 2007.

8. Jacobs BL, et al. Acute lower urinary tract symptoms after prostate brachytherapy with Cesium-131. Urology 75(5):1143-7, 2010.

9. Prestidge B.R., Bice W.S., Jurkovic I., et al. Cesium-131 Permanent Prostate Brachytherapy: An Initial Report. Int. J. Radiation Oncology Biol. Phys. 2005: 63 (1) 5336-5337.

10. Neill B, et al. The Nature and Extent of Urinary Morbidity in Relation to Prostate Brachytherapy Urethral Dosimetry. Brachytherapy 2007:6(3)173-9.

11. Musmacher JS, et al. Dosimetric Comparison of Cesium-131 and Palladium-103 for Permanent Prostate Brachytherapy. Int. J. Radiation Oncology Biol. Phys. 2007:69(3)S730-1.

12. Yaparpalvi R, et al. Is Cs-131 or I-125 or Pd-103 the “Ideal” Isotope for Prostate Boost Brachytherapy? A Dosimetric View Point. Int. J. Radiation Oncology Biol. Phys. 2007:69(3)S677-8.

13. Sutlief S, et al. Cs-131 Prostate Brachytherapy and Treatment Plan Parameters. Medical Physics 2007:34(6)2431.

14. Yang R, et al. Dosimetric Comparison of Permanent Prostate Brachytherapy Plans Utilizing Cs-131, I-125 and Pd-103 Seeds. Medical Physics 2008:35(6)2734.

15. Prestidge B, et. al. Clinical Outcomes of a Phase-II, Multi-institutional Cesium-131 Permanent Prostate Brachytherapy Trial. Brachytherapy. 2007: 6 (2)78.

16. Moran B, et al. Cesium-131 Prostate Brachytherapy: An Early Experience. Brachytherapy 2007:6(2)80.

17. Jones A, et al. IPSS Trends for Cs-131 Permanent Prostate Brachytherapy. Brachytherapy 2008:7(2)194.

18. DeFoe SG, et al. Is There Decreased Duration of Acute Urinary and Bowel Symptoms after Prostate Brachytherapy with Cesium 131 Radioisotope? Int. J. Radiation Oncology Biol. Phys. 2008:72(S1)S317.

19. Bice W, et. al. Recommendations for permanent prostate brachytherapy with 131Cs: a consensus report from the Cesium Advisory Group. Brachytherapy 2008:7(4)290-296.

20. Platta CS, et al. Early Outcomes of Prostate Seed Implants with 131Cs: Toxicity and Initial PSA Dynamics from a Single Institution. Int. J. Radiation Oncology Biol. Phys. 2008:72(S1)S323-4.

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Brachytherapy is Shown to be the Most Cost-Effective Treatment for Prostate Cancer

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