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Higher PSA and Gleason score are
associated with an increased risk of extra-
capsular extension of prostate cancer
Prostate
contour (red)
100% isodose line (yellow)
In I-125 brachytherapy the dose (145Gy) is prescribed to the 100% isodose which should encompass the
prostate with a 3mm margin. Any extra-capsular spread beyond the prostate will not be encompassed and
risks treatment failure so I-125 alone is not recommended with higher PSA or Gleason scores