Acute bowel morbidity after prostate brachytherapy with cesium-131

Abstract 

Purpose

The present study evaluates the severity and time to resolution of bowel symptoms in men undergoing prostate brachytherapy (PB) with cesium-131 (¹³¹Cs).

Methods and Materials

A longitudinal, prospective study of patients who had undergone PB with ¹³¹Cs at a single institution was performed. All patients were asked to complete the Expanded Prostate Cancer Index Composite preoperatively and at 2 weeks and 1, 3, and 6 months postoperatively. Outcomes were analyzed using descriptive statistics and Student’s t test.

Results

The first 142 patients to have undergone PB with ¹³¹Cs at our institution were included in the study. The mean Expanded Prostate Cancer Index Composite bowel summary score at baseline was 90.1±11.0 compared with 71.5±22.8 (p=0.000), 70.1±20.7, 87.1±13.8 (p=0.01), and 90.7±9.2 (p=0.70) at 2 weeks and 1, 3, and 6 months postoperatively, respectively.

Conclusions

In men undergoing PB as monotherapy with ¹³¹Cs, bowel symptoms returned to baseline by 3 months after the procedure. For patients undergoing PB with ¹³¹Cs as part of combination therapy, bowel symptoms return to their post–external beam radiotherapy, pre-PB baseline by 3 months after the procedure.

Keywords: Cesium-131, Quality of life, Brachytherapy, EPIC, Prostate cancer