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Analysis of radioactive implant migration in patients treated with iodine-125 seeds for permanent prostate brachytherapy with MRI-classified median lobe hyperplasia

PURPOSE: Prostate cancer with median lobe hyperplasia (MLH) is a relative contraindication for permanent prostate brachytherapy (PPB) because of an increased risk of post-implant dysuria and technical difficulties associated with achieving stability while implanting within the intravesical tissue. W...

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Autores principales: Muraki, Koichiro, Hattori, Chikayuki, Ogo, Etsuyo, Suefuji, Hiroaki, Eto, Hidehiro, Tsuji, Chiyoko, Miyata, Yusaku, Abe, Toshi, Chikui, Katsuaki, Nakiri, Makoto, Igawa, Tsukasa, Kakuma, Tatsuyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170528/
https://www.ncbi.nlm.nih.gov/pubmed/34122564
http://dx.doi.org/10.5114/jcb.2021.105944
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author Muraki, Koichiro
Hattori, Chikayuki
Ogo, Etsuyo
Suefuji, Hiroaki
Eto, Hidehiro
Tsuji, Chiyoko
Miyata, Yusaku
Abe, Toshi
Chikui, Katsuaki
Nakiri, Makoto
Igawa, Tsukasa
Kakuma, Tatsuyuki
author_facet Muraki, Koichiro
Hattori, Chikayuki
Ogo, Etsuyo
Suefuji, Hiroaki
Eto, Hidehiro
Tsuji, Chiyoko
Miyata, Yusaku
Abe, Toshi
Chikui, Katsuaki
Nakiri, Makoto
Igawa, Tsukasa
Kakuma, Tatsuyuki
author_sort Muraki, Koichiro
collection PubMed
description PURPOSE: Prostate cancer with median lobe hyperplasia (MLH) is a relative contraindication for permanent prostate brachytherapy (PPB) because of an increased risk of post-implant dysuria and technical difficulties associated with achieving stability while implanting within the intravesical tissue. We examined treatment outcome, seed migration, and urination disorders after treatment in MLH patients in order to determine to what degree MLH implants could be stabilized. MATERIAL AND METHODS: Between March 2007 and December 2016, 32 patients had MLH identified radiologically on magnetic resonance imaging, and 193 patients did not have MLH (non-MLH). All patients were treated with loose seeds. In this study, seed migration was defined as a seed distant from the target (≥ 1.5 cm) and/or with no dosimetric contribution to the target. The MLH patients were divided into 2 MLH groups of mild (< 10 mm) and severe (≥ 10 mm) MLH by measuring the distance between the posterior transitional zone and the prostatic tissue protruding into the bladder. We retrospectively analyzed seed migration, dose-volume histograms (DVH), and genitourinary toxicity. RESULTS: MLH was classified as mild in 24 patients and severe in 8. Seed migration occurred in 61 (31.6%) of 193 non-MLH patients and 10 (31.5%) of 32 MLH patients. Implant seed migration and low-dose level of median lobe tended to be high in severe MLH cases. International Prostate Symptom Score (IPSS) peaked one month after implantation, but then resolved slowly and returned to around the pre-treatment level after one year. There were no severe complications. CONCLUSIONS: MLH does not appear to be a strong contraindication for low-dose-rate brachytherapy. However, we found that the seed migration and degree of cold spots tended to be higher in severe MLH cases than in others; therefore, close attention when treating severe MLH cases must be paid.
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spelling pubmed-81705282021-06-11 Analysis of radioactive implant migration in patients treated with iodine-125 seeds for permanent prostate brachytherapy with MRI-classified median lobe hyperplasia Muraki, Koichiro Hattori, Chikayuki Ogo, Etsuyo Suefuji, Hiroaki Eto, Hidehiro Tsuji, Chiyoko Miyata, Yusaku Abe, Toshi Chikui, Katsuaki Nakiri, Makoto Igawa, Tsukasa Kakuma, Tatsuyuki J Contemp Brachytherapy Original Paper PURPOSE: Prostate cancer with median lobe hyperplasia (MLH) is a relative contraindication for permanent prostate brachytherapy (PPB) because of an increased risk of post-implant dysuria and technical difficulties associated with achieving stability while implanting within the intravesical tissue. We examined treatment outcome, seed migration, and urination disorders after treatment in MLH patients in order to determine to what degree MLH implants could be stabilized. MATERIAL AND METHODS: Between March 2007 and December 2016, 32 patients had MLH identified radiologically on magnetic resonance imaging, and 193 patients did not have MLH (non-MLH). All patients were treated with loose seeds. In this study, seed migration was defined as a seed distant from the target (≥ 1.5 cm) and/or with no dosimetric contribution to the target. The MLH patients were divided into 2 MLH groups of mild (< 10 mm) and severe (≥ 10 mm) MLH by measuring the distance between the posterior transitional zone and the prostatic tissue protruding into the bladder. We retrospectively analyzed seed migration, dose-volume histograms (DVH), and genitourinary toxicity. RESULTS: MLH was classified as mild in 24 patients and severe in 8. Seed migration occurred in 61 (31.6%) of 193 non-MLH patients and 10 (31.5%) of 32 MLH patients. Implant seed migration and low-dose level of median lobe tended to be high in severe MLH cases. International Prostate Symptom Score (IPSS) peaked one month after implantation, but then resolved slowly and returned to around the pre-treatment level after one year. There were no severe complications. CONCLUSIONS: MLH does not appear to be a strong contraindication for low-dose-rate brachytherapy. However, we found that the seed migration and degree of cold spots tended to be higher in severe MLH cases than in others; therefore, close attention when treating severe MLH cases must be paid. Termedia Publishing House 2021-05-06 2021-06 /pmc/articles/PMC8170528/ /pubmed/34122564 http://dx.doi.org/10.5114/jcb.2021.105944 Text en Copyright © 2021 Termedia https://creativecommons.org/licenses/by-nc-sa/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/ (https://creativecommons.org/licenses/by-nc-sa/4.0/) )
spellingShingle Original Paper
Muraki, Koichiro
Hattori, Chikayuki
Ogo, Etsuyo
Suefuji, Hiroaki
Eto, Hidehiro
Tsuji, Chiyoko
Miyata, Yusaku
Abe, Toshi
Chikui, Katsuaki
Nakiri, Makoto
Igawa, Tsukasa
Kakuma, Tatsuyuki
Analysis of radioactive implant migration in patients treated with iodine-125 seeds for permanent prostate brachytherapy with MRI-classified median lobe hyperplasia
title Analysis of radioactive implant migration in patients treated with iodine-125 seeds for permanent prostate brachytherapy with MRI-classified median lobe hyperplasia
title_full Analysis of radioactive implant migration in patients treated with iodine-125 seeds for permanent prostate brachytherapy with MRI-classified median lobe hyperplasia
title_fullStr Analysis of radioactive implant migration in patients treated with iodine-125 seeds for permanent prostate brachytherapy with MRI-classified median lobe hyperplasia
title_full_unstemmed Analysis of radioactive implant migration in patients treated with iodine-125 seeds for permanent prostate brachytherapy with MRI-classified median lobe hyperplasia
title_short Analysis of radioactive implant migration in patients treated with iodine-125 seeds for permanent prostate brachytherapy with MRI-classified median lobe hyperplasia
title_sort analysis of radioactive implant migration in patients treated with iodine-125 seeds for permanent prostate brachytherapy with mri-classified median lobe hyperplasia
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8170528/
https://www.ncbi.nlm.nih.gov/pubmed/34122564
http://dx.doi.org/10.5114/jcb.2021.105944
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