Background and objective: Permanent interstitial prostate brachytherapy is the main treatment for early-stage prostate cancer. (125)I and (103)Pd are the most commonly used radionuclides for prostate brachytherapy, which are different in complications and clinical efficacy. This study was to compare the effectiveness and adverse effects of (125)I and (103)Pd for patients with low risk prostate cancer using transperineal prostate seed implantation.
Methods: Systematic literature retrieval was carried out to obtain articles of randomized controlled trials comparing (125)I and (103)Pd brachytherapy for low risk prostate cancer before May 2008. Study selection, data collection and quality assessment of studies were performed by two individual reviewers according to the Cochrane Handbook for systematic reviews of interventions 4.2.6. Statistic analyses were calculated using RevMan5.0 software.
Results: Six randomized controlled trials, a total of 1 406 patients, were included. There was no significant difference in biochemical progression free survival between patients treated with 125I brachytherapy and those treated with (103)Pd brachytherapy [RR=0.97, 95%CI(0.93,1.01)]. At one month after seed implantation, the adverse effects were more severe in (103)Pd group than in 125I group. At six months after seed implantation, the adverse effects were more severe in 125I group than in (103)Pd group. No significant difference in adverse effects was found between the two groups at 12 months after seed implantation.
Conclusion: The individual effects of (125)I and (103)Pd brachytherapy for low risk prostate cancer are similar. However, the side effects are different at different time points after treatment.