Interstitial radiotherapy has been used for the treatment of prostatic cancer since the early 1900s. In 1917 Hugh Young reported a series of patients treated with radium needles implanted transperineally, transrectally, and transurethrally (Young and Fronz 1917). Even with the primitive techniques available, several long-term disease-free survivors were reported (Barringer 1942). With the advent of megavoltage external beam irradiation techniques in the 1950s, Bagshaw clearly demonstrated that radiotherapy is effective in controlling prostatic cancer, previously considered “radioresistant” (Ray and Bagshaw 1975). But with time it became clear that doses in the upper range of clinical tolerance (7000 rad) were necessary to control the local tumor in most patients and that such doses led to a high complication rate when external beam therapy was used alone. Basing their work upon the experience of Flocks et al. (1959), a new generation of urologists and radiotherapists initiated the contemporary experience with interstitial radiotherapy (“brachytherapy”) in an effort to deliver larger doses of irradiation to the prostate with fewer complications. Modern techniques of brachytherapy include implantation of radioactive seeds of gold, iodine, or iridium, with or without external beam irradiation. The major conceptual limitation of brachytherapy, however, remains the problem of a “geographic miss”—failure to irradiate all areas of the tumor sufficiently because of uneven seed placement.
KeywordsProstatic Cancer Radical Prostatectomy Seminal Vesicle External Beam Bladder Neck
Unable to display preview. Download preview PDF.
- Bagshaw MA (1982) Radiation therapy of prostatic carcinoma. In: Crawford ED, Borden TA (eds) Genitourinary cancer surgery. Lea and Febiger, Philadelphia, pp 405–411Google Scholar
- Barringer BS (1942) Prostatic carcinoma. J Urol 47: 306–308Google Scholar
- Brindle JS, Benson RC Jr, Martinez A, Edmundson GK, Zincke H (1985) Acute toxicity and preliminary therapeutic results of pelvic lymphadenectomy combined with transperineal interstitial implantation of 192Ir and external beam radiotherapy for locally advanced prostate cancer. Urology 25: 233–238PubMedCrossRefGoogle Scholar
- Flocks RH, Kerr HD, Elkins HB, Culp DA (1959) The treatment of carcinoma of the prostate by interstitial radiation with radioactive gold (198Au): a follow-up report. J Urol 71: 628–633Google Scholar
- Herr HW (1982) Pelvic lymphadenectomy and iodine-125 implantation of the prostate. In: Johnson DE, Boileau MA (eds) Fundamental principles and surgical technique. Grune and Stratton, New York, pp 63–74Google Scholar
- Hilaris BS, Whitmore WF Jr, Batata MA (1978) Iodine-125 implantation of the prostate: dose response consideration. Front Radiat Ther Oncol 12: 82–90Google Scholar
- Jacobi GH, Hohenfellner R (1982) Staging management and pretreatment reevaluation of prostate cancer. Dogma questioned. In: Jacobi GH, Hohenfellner R (eds) Prostate cancer. Williams and Wilkins, Baltimore, pp 31–56Google Scholar
- Martinez A, Benson RC, Edmundson GK, Brindle J (1985) Pelvic lymphadenectomy combined with transperineal interstitial implantation of iridium-192 and external beam radiotherapy for locally advanced prostatic carcinoma: technical description. Int J Radiat Oncol Biol Phys 11: 841–847PubMedCrossRefGoogle Scholar
- Scardino PT, Carlton CE Jr (1983) Combined interstitial and external radiation for prostatic cancer. In: Javadpour N (ed) Principles and management of urologic cancer. Williams and Wilkins, Baltimore, pp 392–408Google Scholar
- Scardino PT, Wheeler TM (1985) Prostate biopsy after irradiation therapy for prostatic cancer. Urology [Suppl] 25: 39–46Google Scholar
- Young HH, Fronz W (1917) Some new methods in the treatment of carcinoma of the lower genitourinary tract with radium. J Urol 1: 505–536Google Scholar