Postradiation biopsy and histological effects in early-stage prostatic cancer treated with125iodine implants

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Abstract
One hundred twenty patients with adenocarcinoma of the prostate were treated with 125I irradiation to the prostate and pelvic lymphadenectomy. Clinical stages were A‐2 (13 pts), B‐1 (34 pts), B‐2 (49 pts), and C‐1 (24 pts). The tumors were well differentiated in 44%, moderately differentiated in 39% and poorly differentiated in 17%. Nineteen of 22 patients with positive lymph nodes had either moderately or poorly differentiated tumors. A total radiation dosage between 15,000 and 24,000 rads per year were given to all patients. Seventy‐six patients had been rebiopsied at 1 year, and 26 were positive for malignancy (34%). Thirty‐eight patients had rebiopsy at 2 years, and 16 were positive (42%). Forty‐four percent of the postradiation biopsies were of a different histologic grade from the primary lesion. Radiation injury was identified in 95% of the posttreatment biopsies and were moderate or severe in 71%. One hundred one patients are living from 1 to 9 years. Eight patients have died of metastatic carcinoma, and 11 have died of cardiovascular problems.