Iodine-125 seed brachytherapy for early stage prostate cancer: a single-institution review

Abstract

PurposeWe are reporting the five-year biochemical control, toxicity profile and dosimetric parameters using iodine-125 low dose rate brachytherapy (BT) as monotherapy for early stage prostate cancer at a single institution.Material and methodsBetween April 2006 and December 2010, 169 men with early stage prostate cancer were treated with BT. Biochemical failure was defined using the Phoenix definition (nadir + 2 ng/mL). Treatment-related morbidities, including urinary, rectal and sexual function, were measured, applying the International Prostate Symptom Score (IPSS), the 7-grade Quality of Life Scale (QoL) and medical status, the International Consultation on Incontinence Modular Questionnaire (ICIQ), the International Index of Erectile Function (IIEF-5) and the Common Terminology Criteria for Adverse Events (CTCAE v4.03). Seed migration and loss, dosimetric parameters and learning effects were also analyzed.ResultsMedium follow-up time was 50 months (range, 1–85 months). The five-year biochemical failure rate was 7%. Acute proctitis rates were 19% (grade 1) and 1% (grade 2), respectively. The overall incidence of incontinence was 19% (mild), 16% (moderate) and < 1% (severe). An increase in IPSS ≥ 5 points was detected in 59% of patients, with 38% regaining their baseline. Seed dislocation was found in 24% of patients and correlated with D90 and V100. A learning curve was found for seed migration, D90 and V100. QoL correlated with the general health condition of patient, incontinence symptoms and IPSS.ConclusionsBT for early stage prostate cancer offers excellent five-year biochemical control with low toxicities. QoL aspects are favorable. A learning curve was detected for procedural aspects but its impact on patient relevant endpoints remains inconclusive.

Efficacy and safety of iodine-125 brachytherapy combined with chemotherapy in the treatment of advanced NSCLC in the elderly

“…As an internal RT, iodine-125 seed implantation has been successfully used to treat a series of malignant tumors, such as prostate cancer, 24 brain tumors, 25 , 26 pancreatic cancer, 27 skin cancer, 28 ovarian cancer, 29 recurrent cervical cancer, 30 and head and neck neoplasms, 31 especially in NSCLC. Santos et al indicated that the use of iodine-125 brachytherapy after sublobar resection significantly improved local control compared with sublobar resection alone (18.6 vs 2%; P <0.0001).…”

Oligorecurrence Non–small Cell Lung Cancer After Failure of First-Line Chemotherapy: Computed Tomography–Guided 125I Seed Implantation vs. Second-Line Chemotherapy

“…Recently, RIS implantation brachytherapy has been successfully used to treat diverse kinds of malignant tumors (17,(23)(24)(25)(26). A large quantity of studies on RIS implantation for NSCLC have been reported with promising results.…”

“…Radioactive 125 I seed (RIS) brachytherapy recently has been a standard treatment in early low-to intermediate-risk prostate cancer (16,17). It is a type of low-dose-rate brachytherapy, which could deliver high radiation dose to target tumor while safely sparing the adjacent normal tissue.…”

Effect of pedicle fixation combined with 125I seed implantation for metastatic thoracolumbar tumors

“…Initially, this method was used to treat prostate cancer in clinical practice and achieved satisfactory efficacy. 6 To date, this method has been used to treat tumors in multiple systems, including lung cancer and pancreatic cancer. Literature sources have reported that this method can relieve some symptoms and elongate patient survival with satisfactory efficacy.…”