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  • Title: [Cancer of the prostate: technics of curietherapy. Review of the literature and experience at the Institut Gustave-Roussy].
    Author: Chassagne D, Court B, Gerbaulet A, Perrin JL, Haie C.
    Journal: Bull Cancer; 1985; 72(6):578-84. PubMed ID: 4092108.
    Abstract:
    Pasteau and Degrais in Paris used radium to treat prostatic cancer in 1907, radium was further used with different techniques including radium needles and radon seeds during twenty years. In 1951, Flock advocated colloidal radioactive gold with interesting palliative results. Permanent gold seeds implant was also used. But until 1970 with the appearance of Iodine 125 grain, brachytherapy was not widely employed. Hilaris and Whitmore treated almost 1000 cases until now, with few immediate complications. Survivals at 5 years are T1 96%, T2 76%, T3 69%. Conservation of potency and absence of late complications are the main benefits. However, the technique is a somewhat complex surgical procedure and the cases have to be carefully selected. Many others centers used iodine technique and Holm recently proposed an ingenious per-operative echography to improve the safety and accuracy of the permanent implantation. Removable implants with 192Ir wire (or nylon ribbon seeds) are obviously simpler and safer to implant through perineal route. For us, flexible plastic tubes is the technique of choice. In ten cases irradiated at 70 Gy level, no recurrences and no complications except one pulmonary embolism, but the patients were highly selected. For Syed rigid needles through perineal template is the technique of choice. External radiation is added after the implant, which delivered a dose of about 30 Gy. The results are satisfactory in the first 100 cases, but with a high level of complication. Comparative series and more follow-up are evidently requested, to know the exact place of brachytherapy in the treatment of prostatic adenocarcinoma.
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