Seed migration after transperineal interstitial prostate brachytherapy by using loose seeds: Japanese prostate cancer outcome study of permanent iodine-125 seed implantation (J-POPS) multi-institutional cohort study

Masahiro Nakano, Atsunori Yorozu, Shiro Saito, Akitomo Sugawara, Shinichiroh Maruo, Shinsuke Kojima, Takashi Kikuchi, Masanori Fukushima, Takushi Dokiya, Hidetoshi Yamanaka, Masahiro Nakano, Atsunori Yorozu, Shiro Saito, Akitomo Sugawara, Shinichiroh Maruo, Shinsuke Kojima, Takashi Kikuchi, Masanori Fukushima, Takushi Dokiya, Hidetoshi Yamanaka

Abstract

Background: The incidence and associated factors of loose seed migration were investigated in cohort 1 of the Japanese Prostate Cancer Outcome Study of Permanent Iodine-125 Seed Implantation (J-POPS).

Methods: The study subjects were 2160 patients, consisting of 1641 patients who underwent permanent iodine-125 seed implantation (PI) and 519 patients who underwent PI combined with external beam radiation therapy (PI + EBRT). The presence or absence of seed migration to the chest and abdominal/pelvic region was determined.

Results: Seed migration was observed in 22.7 % of PI group patients and 18.1 % of PI + EBRT group patients (p = 0.0276). Migration to the lungs and abdominal/pelvic region was observed in 14.6 % and 11.1 % of the patients in the PI group, and 11.2 % and 8.5 % of the patients in the PI + EBRT group, respectively. In the PI group, the number of implanted seeds was associated with the seed migration incidence. Neither the PI nor the PI + EBRT group showed any difference in the volume of the prostate receiving 100 % of the prescribed dose (V100 [%]) or the minimal dose received by 90 % of the prostate volume (D90 [Gy]) between the patients with and without seed migration.

Conclusions: This prospective cohort study investigating the largest number of past cases showed no difference in D90 (Gy) or V100 (%) between seed migration or the absence thereof in both the PI group and PI + EBRT group.

Trial registration: ClinicalTrials.gov: NCT00534196.

Figures

Fig. 1
Fig. 1
Dosimetric comparison of migration numbers. a: D90 (Gy), b: V100 (%) D90 (Gy) = minimal dose received by 90 % of the prostate volume; V100 (%) = volume of the prostate receiving 100 % of the prescribed dose; PI = permanent iodine-125 seed implantation; PI + EBRT = PI combined with external beam radiation therapy *: Wlicoxon singed-rank test
Fig. 2
Fig. 2
Seed migration rates of each chest X-P methods. PI = permanent iodine-125 seed implantation; PI + EBRT = PI combined with external beam radiation therapy; PA = posterior-anterior *: Chi square test
Fig. 3
Fig. 3
Seed migration rates according to the number of years registered in J-POPS. J-POPS = Japanese Prostate Cancer Outcome Study of Permanent Iodine-125 Seed Implantation; PI = permanent iodine-125 seed implantation; PI + EBRT = PI combined with external beam radiation therapy *: Chi square test

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