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Radiotherapy is an option and a wax Lucite block can be used as a chamber to hold the penis.

Dr. Juanita Crook is of the opinion that the majority of small very superficial lesions are best treated surgically. However, radiotherapy is an option and a wax Lucite block can be used as a chamber to hold the penis. This permits a full bolus of radiation to the skin surface. 5-year disease-free rates are about 61% with penile preservation rates about 55-60%.

Brachytherapy is also an option, and it mandates a pre-treatment circumcision. The dose is 60Gy given over 5 days. It can be done under local or general anesthesia. 74 cases were treated in Canada over a 19 year period.

The Paris system of dosimetry with a 2-plane implant was used. The implants remained in place for 5 days. The radiation covers an area of 1cm beyond the tumor. Uretheral stenosis occurred in 9% and soft tissue necrosis in 12%. Erectile function was maintained in the majority. There is mild to moderate penile fibrosis and pigmentation change. The 5-year disease-free rate is 88% but decreases at 10 years to 70%.

Source: UroToday

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