Results with Prostate Seed Implants


Since seed implants are confined to the gland (generally all the seeds are deposited inside the capsule of the gland) the results with seed implants alone are best for patients with cancer confined to the gland. A recent study comparing seed implants with surgery or external beam irradiation (D'Amico in JAMA 1998;280:969) showed seed results identical for early stage cancer but worse results for seeds in higher risk patients (i.e. stage T2b or higher, Gleason score 7 or higher and PSA 10 or higher.) Seed implants alone are restricted to patents whose tumors are thought to be confined to the gland (within the capsule) otherwise we use external beam irradiation or combined external beam plus seed implantation as a boost. See table. Seed implants using the modern technique (implanted from perineum using an ultrasound) have only been performed for about10 years. The 8 year statistics (bNED, which means that at 8 years the PSA were still very low or < 1) from Seattle using either palladium-103 (11.5Gy) or Iodine-125 ((16Gy)were recently reported (Onc News Int 1998;7:26) control by Gleason was 89% for GS 2-6 and only 48% for GS 7-10, by stage and PSA as below: The Seattle group recently published their 10 year statistics as noted.