Penis carcinomas are rare disease, representing less than 1% of tumors that attack males. Their frequency increases in less developed countries.
The European Association of Urology recommends organ-preserving treatment only for stages Ta and T1 G1-2. A partial or complete penis amputation is preferred in stages T1 G3 and stage T2.
Indications for brachytherapy alone include a histologically confirmed carcinoma up to 4 cm in size and restricted to the penile glands, which has not infiltrated the penile body.
Surgical treatment is preferred for tumors > 4 cm. Should the patient refuse this option, a combined external beam radiation therapy and brachytherapy approach can be carried out.
Data in the literature indicate that the survival rate among T1 and T2 tumors treated with interstitial brachytherapy is up to 90% after 10 years and that 80%–85% local control can be achieved. While 20%–30% of patients developed side effects, the penis remained intact in 72%–80% of all patients. Compared with surgical methods, this represents the greatest advantage of brachytherapy.