Hormone Therapy Followed By Internal Radiation Therapy in Treating Patients With Locally Recurrent Prostate Cancer

DISEASE CHARACTERISTICS:

• Histologically confirmed locally recurrent or persistent prostate adenocarcinoma

  • Locally recurrent disease
  • Prostate-specific antigen (PSA) no greater than 10 ng/mL

  • N0 and M0 (at time of initial diagnosis and at time of local recurrence)

    • Lymph nodes must be negative or will be negative after nodal sampling or dissection
• More than 18 months after completion of prior external beam radiotherapy

• Must have had 1 of the following disease characteristics prior to external beam radiotherapy:

  • T1-2a, Gleason score 2-6, and PSA no greater than 15 ng/mL
  • T1-2a, Gleason score 7, and PSA no greater than 4 ng/mL
  • T2b, Gleason score 2-6, and PSA no greater than 6 ng/mL
• Must have American Urological Association Symptom Index score no greater than 15
• Transrectal ultrasound-determined prostate planimetry volume no greater than 60 mL
• No pubic arch interference of more than 1/3 the prostatic volume determined by transrectal ultrasound or pelvic CT scan

PATIENT CHARACTERISTICS:

Age:

• 18 and over

Performance status:

• Zubrod 0-1 OR
• ECOG 0-1

Life expectancy:

• At least 5 years

Other:

• No persistent late intestinal or bladder toxicity grade 2 or greater
• No other major medical or psychiatric illness that would preclude study
• No metallic hip prosthesis
• No other malignancy within the past 5 years except localized basal cell or squamous cell skin cancer
• No other concurrent illness that would limit life expectancy
• Suitable for spinal or general anesthesia
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

Chemotherapy:

• No prior chemotherapy for prostate cancer

Endocrine therapy:

• At least 12 months since prior androgen suppression except goserelin or leuprolide with flutamide or bicalutamide begun within the past 30 days

Radiotherapy:

• See Disease Characteristics
• No prior external beam radiotherapy doses exceeding 71 Gy to the prostate
• No prior radionuclide prostate brachytherapy

Surgery:

• No prior transurethral prostate resection
• No prior prostatectomy or prostatic cryosurgery
• No prior bilateral orchiectomy

Other:

• No concurrent participation in another medical research study for prostate cancer treatment