Prostate Seed Implant Results
sexr.jpg (5261 bytes) Basic Results

overall
long term
more

 

 

 Comparisons

seeds versus external
iodine vs palladium
seeds alone
more on seeds alone
seeds plus external
surgery comparisons
seeds plus hormones

 Outcome

follow up tests
complications

 

 
   
 

 Results with seed implants are worse for patients with a higher Gleason Score (see here.) For low risk patients (stage T1c or T2a, Gleason 6 and PSA < 10, if the patient gets a good seed implant (optimal means the D90 dose = prescription dose) then the PSA cure rates at 8 years may be 94% (see here.) More studies show the importance of getting the proper dose to the cancer (see here, here, and here). The lower the PSA declines the better chance of cure (go here),

The longest published outcome results are 13 years and 15 years

 

   

Typical comparison studies include a local study of 1,305 T1/T2 patients treated with seeds (869) or radical prostatectomy (208) Curr Urol Rep 2002 Jun;3(3):250-7
Cure rates at 7 Years
Initial PSA level Seeds Radical Prostatectomy
0 - 4 90% 97%
4 - 10 76% 65%
10 - 20 64% 66%
 

other studies are similar to that noted below

The effect of prognostic factors on therapeutic outcome following transperineal prostate brachytherapy.
Stock RG, Stone NN,    Semin Surg Oncol 1997 Nov-Dec;13(6):454-60
Department of Radiation Oncology, Mount Sinai Medical Center, New York, New York 10029, USA.

Cure Rates (bNED) at 4 Years by Group
PSA  
< 10 75%
10 - 20 74%
> 20 34%
Gleason  
2 - 4 81%
5 - 6 65%
7+ 47%
Low Risk (GS 6, PSA<10) 88%

The objectives of this study were to examine the effect of both disease and treatment related prognostic factors on biochemical control and post-treatment biopsy. Two-hundred fifty-eight patients underwent interactive ultrasound guided transperineal prostate implantation for T1-T2 prostate cancer using Iodine-125 (139 patients) and Palladium-103 (119 patients) and were followed from 6-67 months (median, 19). Hormonal therapy with 3 months of leuprolide and flutamide prior to implantation and two months given after the implant was used in 96 patients. Pre-treatment prostate-specific antigen (PSA) had the most significant effect on biochemical failure. Freedom from biochemical failure (FFBF) rates at 4 years were 75% for patients with PSA 1.3-10 ng/ml (144), 74% for patients with PSA 10.1-20 ng/ml (73), and 34% for patients with PSA > 20 ng/ml (41) (P = 0.0004). Gleason score also had a significant effect on FFBF rates. Four-year rates were 81%, 65% and 47% for patients with scores of 2-4 (68), 5-6 (130), and > or = 7 respectively (60) (P = 0.01). These two factors were also significant in multivariate analysis (P = 0.002, 0.007, respectively). Gleason score was the only factor to significantly affect post-treatment biopsy results. Patients with scores of 2-6 had 85% (63/ 74) negative 2-year biopsies versus 62% (13/21) for patients with scores > or = 7 (P = 0.02). Low-risk patients (PSA < or = 10 ng/ml, scores < 7 and stage < T2a) had a 4-year FFBF rate of 88% as compared to 60% for high-risk patients (PSA > 10 ng/ml, score > 6 or stage > or = T2b) (P = 0.02) and had a 95% negative biopsy rate versus 76% for high-risk patients (P = 0.06). Low-risk patients demonstrate high FFBF and negative biopsy rates following implantation. Patients presenting with higher risk prognostic factors such as PSA > 20 ng/ml or Gleason scores > or = 7 may require more aggressive treatment regimens.