Treatment of XXXX with interstitial iridium-192 implantation and external beam irradiation.

@entity1 @entity12817 @entity1494 @entity189 @entity150
Although interstitial implantation of invasive @entity150 has been shown to be an effective treatment in Europe, there has been little experience with this method in the U.S. During the past 6 years, 14 @entity1 at the Hospital of the University of Pennsylvania with single @entity150 less than 5 cm and no evidence of @entity189 in situ on random bladder biopsies have been treated by a combination of external beam radiation and iridium wire implant. The iridium wire is inserted by an afterloading technique following tumor exposure via suprapubic cystotomy. Following delivery of the prescribed dose, the sources are removed percutaneously. Three @entity1 with recurrent or high grade T1 lesions and 11 @entity1 with T2- @entity12817 lesions have been treated. With a median follow-up of 22 months (range 17 to 65 months), 9 @entity1 are currently NED, 4 @entity1 have died of disease, and 1 @entity1 has died of intercurrent disease. There have been two isolated @entity1494 , both non-invasive, one having been treated with cystectomy and one being treated locally. In addition, one @entity1 developed regional failure, two developed distant metastases only, and one developed local recurrence following distant failure. The 2-year actuarial local control rate is 84%, with an overall 2-year actuarial survival of 66%. Complications have been minimal. Bladder implantation by this method is technically simple and produces excellent local control with acceptable morbidity.
