Dear Doctor,
During the last 10 years, the Institute has performed extensive research and development on 3-D CT-guided brachytherapy using a stereotactic system and posterior pararectal approach to treat prostate cancer. This method allows for precise placement of radioactive seeds without obstruction by the pubic arch. Our patient population (1,000) has included those with large prostate (Figure 1), prior transurethral resection, protrusion of the median-lobe into the urinary bladder (Figure 2), seminal vesicle invasion, local recurrence after radical prostatectomy, and absence of rectum due to previous surgery for colorectal cancer.
Prostate cancer is very often multigraded and multicentric, and for this reason, we have found it is preferred to treat the entire prostate gland.
With the use of 125I or 103Pd seeds-in-strand with lesser activity of seeds around the urethra and prostate adjacent to the anterior rectal wall, gastrointestinal and urinary morbidity has dramatically diminished in the last 5 years. In our 10 years experience, our biochemical results are excellent with 89%, 94%, and 95% disease-free survival rate in high, intermediate, and low-risk patients, respectively. The high risk patients include 79 with biopsy-proven seminal vesicle invasion.
We encourage you to visit our institute and become acquainted with our method of treatment. If you require any assistance for your patients please let us know. For more information please visit our website at www.prostatebrachytherapy.info. In addition, copies of our publications in PDF format may be downloaded from our website. You may also contact me by email at pgkurpi@aol.com.
Best regards,
Panos G. Koutrouvelis, M. D.
Radiation Oncologist and Director, URPI
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Figure 1. CT dosimetry during implant of large gland.
The urethra (green circle) is in the periphery near the anterior rectal wall.
Figure 2. Protrusion of the median-lobe into urinary bladder.
CT dosimetry during implant. There is excellent coverage of the median-lobe.
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