Inclusion Criteria
Male patient diagnosed with prostate adenocarcinoma, confirmed by histopathology
Age ≥50 years old
Low- and Intermediate-risk prostate carcinoma as defined by the NCCN version 2.2012
• Low-risk: ≤ csT2a, Gleason ≤ 6, PSA ≤ 10
• Intermediate-risk: = csT2b-c, Gleason 7, PSA=10-20
Surgical clearance
ECOG performance status of 0-1
No pubic arch interference or anatomical variants that would preclude a satisfactory implant as determined by pre-operative radiologic assessment (CT, MRI, ultrasound as indicated)
Pre-operative approval by primary care provider, cardiologist or other qualified clinician
Exclusion Criteria
History of prior radiotherapy to prostate or pelvis
Prior prostate surgery such as transurethral resection of the prostate (TURP)
History of prior chemotherapy for prostate cancer
Significant pelvic CT/MRI artifact distortion due to prior surgical implants (e.g. hip implants)
High-risk prostate carcinoma: >csT3, Gleason 8-10, PSA >20
Prostate volume >60 cm3
History of autoimmune disorders (e.g. inflammatory bowel disease, CREST syndrome, scleroderma, lupus)
Clinical, radiological or pathological confirmed/suspected T3b, N1, or M1 per 7th ed. AJCCC staging manual
Pre-existing rectal fistula
Medically contraindicated for surgery or anesthesia
Determined to be unfit for procedure by primary care provider, cardiologist, or other qualified clinician
Abbreviations: PSA=prostate specific antigen, NCCN=National Cancer Cooperative Network, ECOG=Eastern Cooperative Oncology Group
Table 1: Patient selection criteria.