PURPOSE: To compare dosimetric parameters, seed migration rates, operation times, and acute toxicities of intraoperatively built custom-linked (IBCL) seeds with those of loose seeds for prostate brachytherapy.
METHODS AND MATERIALS: Participants were 140 patients with low or intermediate prostate cancer prospectively allocated to an IBCL seed group (n=74) or a loose seed group (n=66), using quasirandomization (allocated by week of the month). All patients underwent prostate brachytherapy using an interactive plan technique. Computed tomography and plain radiography were performed the next day and 1 month after brachytherapy. The primary endpoint was detection of a 5% difference in dose to 90% of prostate volume on postimplant computed tomography 1 month after treatment. Seed migration was defined as a seed position >1 cm from the cluster of other seeds on radiography. A seed dropped into the seminal vesicle was also defined as a migrated seed.
RESULTS: Dosimetric parameters including the primary endpoint did not differ significantly between groups, but seed migration rate was significantly lower in the IBCL seed group (0%) than in the loose seed group (55%; P< .001). Mean operation time was slightly but significantly longer in the IBCL seed group (57 min) than in the loose seed group (50 min; P< .001). No significant differences in acute toxicities were seen between groups (median follow-up, 9 months).
CONCLUSIONS: This prospective quasirandomized control trial showed no dosimetric differences between IBCL seed and loose seed groups. However, a strong trend toward decreased postimplant seed migration was shown in the IBCL seed group.
Written by:
Ishiyama H, Satoh T, Kawakami S, Tsumura H, Komori S, Tabata KI, Sekiguchi A, Takahashi R, Soda I, Takenaka K, Iwamura M, Hayakawa K. Are you the author?
Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Sagamihara, Japan; Department of Urology, Kitasato University School of Medicine, Sagamihara, Japan.
Reference: Int J Radiat Oncol Biol Phys. 2014 Jun 28. pii: S0360-3016(14)00593-8.
doi: 10.1016/j.ijrobp.2014.05.009
PubMed Abstract
PMID: 24986744
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