Interstitial radiotherapy using iridium 192 wires for carcinoma of the penis

Sixteen patients with carcinoma of the penis were treated between October 1984 and January 1989 in the department of Radiation Oncology of the Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. All patients were treated with interstitial implants using iridium 192 wires, associated in 1 patient with partial penectomy, in 3 patients with external radiation therapy and in 1 patient with chemotherapy. Two patients underwent inguinal node dissection and sentinel lymph node (SLN) biopsy was performed in 1 patient. The group included 8 patients with T1 tumors, 6 with T2 tumors and 2 with T3 tumors. Fourteen patients presented with no metastatic inguinal nodes (NO), and 2 patients had N1 nodes. Two patients developed local recurrence 5 and 18 months after implant: these 2 patients underwent penile amputation and are alive and well 21 and 38 months following brachytherapy. Two patients developed urethral stenosis. Two patients developed delayed metastatic nodes at 6 and 8 months after implant: 1 patient died of uncontrolled regional disease at 14 months and 1 patient is alive with regional disease at 20 months following brachytherapy. Two patients died of intercurrent disease at 6 (broncogenic carcinoma) and 25 (accident) months following interstitial radiation therapy without evidence of local disease. Overall survival rate was 79% at 4 yr and disease-free survival rate was 74% at 4 yr. Considerations regarding local and regional treatment of carcinoma of the penis are discussed in this paper.