What isotope and dose do you prefer for prostate brachytherapy monotherapy?

Superior dosimetry - palladium 103

• Faster half-life decay
• Lower risk to the patient's family and medical personnel
• Less of an issue with subsequent urologic procedures such as TURP

Agree with Dr. @Dr. First Last and also Dr. @Dr. First Last's excellent comments about LDR implants. I would add that the shorter half life and lower energy with Pd-103 allow for faster return to normal urinary function and greater rectal sparing. In prior experience (Serrano et al., PMID 25413406),...

There is one thing to keep in mind when choosing Pd-103 over I-125. Pd-103 is much less "forgiving" of a suboptimal seed distribution. In my experience (over 35 years) with both, I-125 implants tend to be more "homogeneous".

In my experience, there have been several secondary squamous cell bladder cancers after brachytherapy and all were I-125. My thoughts are that the total numbers are small and therefore, really difficult to interpret but there may be a more carcinogenic effect with "chronic irritation" of a longer ha...