Transurethral intracavitary irradiation for carcinoma of the prostate

This paper describes a new technique and preliminary clinical results of remote after-loading transurethral irradiation for cancer of the prostate. As of January 1986, twelve patients with adenocarcinoma of the prostate have been treated by our radiotherapy technique. Clinically, 3 patients were in stage B2, 3 in stage C, 3 in stage D1 and 3 in stage D2. These patients have been followed up for 13 to 33 months with a median follow-up period of 20.6 months. The dose of transurethral irradiation was 9-10 Gy. to the prostatic capsule and about 2 Gy. to the rectum in one procedure. We repeated this radiotherapy 3 to 4 times within an about 1-month period. Three patients in stage D1 and one patient in stage C received an additional external beam radiation (40 Gy.) to the entire pelvis. A needle biopsy was also performed every 4-6 months after irradiation. Local tumor response proved rapid and satisfactory as verified by a rectal examination and ultrasonography. The biopsies revealed a 70% negative rate within one year. The most common side effect was transient frequency observed in 7 patients. Severe complications such as incontinence, urethral stricture, or proctitis were not evident. This study suggests that intracavitary irradiation of cancer of the prostate is effective and safe. This method may have wider application.