Use of brachytherapy with permanent implants of iodine-125 in localized prostate cancer

Approximately 15,000 cases of early stage prostate cancer T1 andT2 are diagnosed every year in France by testing for PSA and performingprostatic biopsies. The treatment of these localized forms isbased in most cases on radical prostatectomy or on external beamradiotherapy. Although the oncological results obtained by thesetwo therapeutic methods are satisfactory and equivalent in the longterm, the side effects can be important. For a number of years,transperineal brachytherapy using permanent implants of iodine-125 or palladium-103 has proved itself as an alternative therapywith equivalent medium to long-term results. The low urinary, digestiveand sexual side effects of prostate brachytherapy are importantreasons for the enthusiasm among patients and the medicalcommunity for this therapy and the growing number of applicationsand centres which practice it.In September 1998 we started the prostate brachytherapy programmesin Marseilles with close collaboration between the departmentof urology of the Hôpital Salvator, and the departments of radioth erapy,medical imaging and medical physics of the Institut Paoli-Calmettes. To date, around 250 patients with localized adenocarcinomaof the prostate have benefited from this alternative therapy inour centre. Preliminary results, with a 3 year-follow-up, are comparableto results published in the literature by pioneer teams.