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I-125 versus Pd-103 for Low-Risk Prostate Cancer: Morbidity Outcomes from a Prospective Randomized Multicenter Trial, Kent Wallner, MD, Gregory Merrick, MD, Lawrence True, MD, William Cavanagh, BA, Colleen Simpson, RN, and Wayne Butler, PhD. The Cancer Journal, 2002;8(1):67-73.
| Type of Study |
Compared the severity and duration of side effects experienced by patients following brachytherapy treatment with palladium-103 (Pd-103) or iodine-125 (I-125). |
| Purpose |
To compare duration of radiation-related symptoms after Pd-103 brachytherapy to I-125. |
| Issue |
How do palladium-103 (Pd-103) implants compare to iodine-125 (I-125) implants?
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| Number of Patients |
110, randomly assigned to receive Pd-103 or I-125 brachytherapy. |
| Type of Patients |
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Stage T1c – T2a prostate cancer (according to 1997 American Joint Commission criteria). |
| • |
Gleason grades 2-6. |
| • |
PSA levels 4-10. |
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| Length of Time
Patients Were Followed |
One year. |
| Results and/or
Conclusions |
Patients treated with Pd-103 recovered from radiation-related prostatitis sooner than I-125 patients.
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In a comparative study of Pd-103 and I-125 -- both used in brachytherapy treatment of prostate cancer -- 110 patients were randomly assigned to receive one of the implants.
The authors provided a historical perspective regarding the use of both isotopes in prostate cancer treatment. “Although both isotopes offer the practical advantage of low energies…marked differences exist between the isotopes in regard to the initial dose rate,” the study states. “There is a theoretical concern that the low dose rate of I-125 is not sufficient to sterilize some prostate tumors, as a result of cell proliferation and radiation damage repair during the life of the implant. Partly out of concern over the dose rate of I-125 implants, Pd-103 was introduced in 1986...”
“There was a trend to greater morbidity with I-125 than with Pd-103, most markedly at the 6-month time point.” Overall, the study concluded, “Patients treated with Pd-103 recovered from their radiation-induced prostatitis sooner than I-125 patients. It appears that patients with minimal pretreatment urinary obstructive symptoms are the most likely to experience implant-related exacerbations of their symptoms and are the most likely to benefit from the more rapid half-life of Pd-103 rather than I-125.”
Principal Investigator: Kent Wallner, M.D., Puget Sound VA, Group Health Cooperative, Seattle, Wash.
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