Does Seed Migration Increase the Risk of Second Malignancies in Prostate Cancer Patients Treated With Iodine-125 Loose Seeds Brachytherapy?

Vigneault, Éric; Martell, Kevin; Taussky, Daniel; Husain, Siraj; Delouya, Guila; Mbodji, Khaly; Piotte, Julie; Magnan, Sindy; Després, Philippe; Lavallée, Marie-Claude; Aubin, Sylviane; Beaulieu, Luc; Foster, William; Martin, André-Guy

doi:10.1016/j.ijrobp.2017.12.273

Cited by 6 publications

(7 citation statements)

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“…Extracranial 125 I Radiation Produces Site-and Dose-Dependent Effect 125 I is a radioisotope that emits γ rays with a low average photon energy of 28.5 keV, with a half-life of approximately 60 days (Krishnaswamy,1978). As elaborated in the Introduction, 125 I seeds are commonly used in brachytherapy of many solid tumors (Schwarz et al, 2012;Wang et al, 2016;Zhang et al, 2016;Hirose et al, 2017;Brun et al, 2018;Vigneault et al, 2018;Zhu et al, 2019;Jia et al, 2020;Li et al, 2020;Watson et al, 2020). Given that radiation in general can result in inhibition or elimination of neurogenesis by blocking cell proliferation (Mizumatsu et al, 2003;Tan et al, 2011), we sort to establish a method to block AHN via localized extracranial application of 125 I seeds using guinea pigs as experimental model.…”

Section: Discussionmentioning

confidence: 99%

“…Based on the principle that radiation can inhibit cell division and damage proliferative cells, 125 I seeds are used for brachytherapy of multiple solid tumors, such as lung cancer, liver cancer, prostate cancer, kidney cancer, bone metastases, and intracranial tumors ( Schwarz et al, 2012 ; Wang et al, 2016 ; Zhang et al, 2016 ; Hirose et al, 2017 ; Brun et al, 2018 ; Vigneault et al, 2018 ; Zhu et al, 2019 ; Jia et al, 2020 ; Li et al, 2020 ; Watson et al, 2020 ). The seeds are composed of a titanium tube in the center (diameter 0.8 mm, length 4.5 mm, wall thickness 0.05 mm) and a permeable silver rod at the periphery (diameter 0.05 mm, length 3 mm).…”

Section: Introductionmentioning

confidence: 99%

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Extracranial 125I Seed Implantation Allows Non-invasive Stereotactic Radioablation of Hippocampal Adult Neurogenesis in Guinea Pigs

et al. 2021

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Adult hippocampal neurogenesis (AHN) is important for multiple cognitive functions. We sort to establish a minimal or non-invasive radiation approach to ablate AHN using guinea pigs as an animal model. 125I seeds with different radiation dosages (1.0, 0.8, 0.6, 0.3 mCi) were implanted unilaterally between the scalp and skull above the temporal lobe for 30 and 60 days, with the radiation effect on proliferating cells, immature neurons, and mature neurons in the hippocampal formation determined by assessment of immunolabeled (+) cells for Ki67, doublecortin (DCX), and neuron-specific nuclear antigen (NeuN), as well as Nissl stain cells. Spatially, the ablation effect of radiation occurred across the entire rostrocaudal and largely the dorsoventral dimensions of the hippocampus, evidenced by a loss of DCX+ cells in the subgranular zone (SGZ) of dentate gyrus (DG) in the ipsilateral relative to contralateral hemispheres in reference to the 125I seed implant. Quantitatively, Ki67+ and DCX+ cells at the SGZ in the dorsal hippocampus were reduced in all dosage groups at the two surviving time points, more significant in the ipsilateral than contralateral sides, relative to sham controls. NeuN+ neurons and Nissl-stained cells were reduced in the granule cell layer of DG and the stratum pyramidale of CA1 in the groups with 0.6-mCi radiation for 60 days and 1.0 mCi for 30 and 60 days. Minimal cranial trauma was observed in the groups with 0.3– 1.0-mCi radiation at 60 days. These results suggest that extracranial radiation with 125I seed implantation can be used to deplete HAN in a radioactivity-, duration-, and space-controllable manner, with a “non-invasive” stereotactic ablation achievable by using 125I seeds with relatively low radioactivity dosages.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Extracranial 125I Seed Implantation Allows Non-invasive Stereotactic Radioablation of Hippocampal Adult Neurogenesis in Guinea Pigs

et al. 2021

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“…It is important to note that considerable difficulty is routinely encountered when attempting to dose paint intra-operatively in the base area due to intentional avoidance of the peri-urethral area and bladder neck and difficulty creating hot spots in the anterior fibromuscular zone (needles intruding on urethra were routinely rejected during planning and dose to bladder neck was limited to reduce toxicity) [39]. Additionally, there is a tendency for all seeds to settle inferiorly and posteriorly after implantation and a risk of seed loss into the bladder [40,41]. The association between inferior FFBF and DIL in the base (HR 1.03) might be attributable to this underlying limitation.…”

Section: Discussionmentioning

confidence: 99%

Analysis of outcomes after non-contour-based dose painting of dominant intra-epithelial lesion in intra-operative low-dose rate brachytherapy

Martell

Roy

Meyer

et al. 2020

Heliyon

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To compare the outcomes of patients with intermediate risk prostate cancer (IR-PCa) treated with lowdose rate I-125 seed brachytherapy (LDR-BT) and targeted dose painting of a histologic dominant intra-epithelial lesion (DIL) to those without a DIL. Methods: 455 patients with IR-PCa were treated at a single center with intra-operatively planned LDR-BT, each following the same in-house dose constraints. Patients with a DIL on pathology had hot spots localized to that region but no specific contouring during the procedure. Results: 396 (87%) patients had a DIL. Baseline tumor characteristics and overall prostate dosimetry were similar between patients with and without DIL except the median number of biopsy cores taken: 10 (10-12) vs 12 (10-12) (p ¼ 0.002). 19 (5%) and 18 (5%) of patients with and 1 (2%) and 0 (0%) of those without DIL experienced CTCAE grade 2 and 3 toxicity respectively. Overall, toxicity grade did not significantly correlate with presence of DIL (p ¼ 0.10). Estimated 7-year freedom from biochemical failure (FFBF) was 84% (95% confidence interval: 79-89) and 70% (54-89) in patients with and without a DIL (log-rank p ¼ 0.315). In DIL patients, cox regression revealed location of DIL ("Base" vs "Apex" HR: 1.03; 1.00-1.06; p ¼ 0.03) and older age (70 vs 60 HR: 1.62; 1.06-2.49; p ¼ 0.03) was associated with poor FFBF. Conclusions: Targeting DIL through dose painting during intraoperatively planned LDR-BT provided no statistically significant change in FFBF. Patients with DILs in the prostate base had slightly lower FFBF despite DIL boost.

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“…In addition, seed migration after I-125 implantation did not increase the risk of second malignancies for prostate cancer patients. However, a longer follow-up was required to further investigate the correlation between seed migration with secondary malignancies ( 144 ).…”

Section: I-125 Brachytherapy In Solid Tumorsmentioning

confidence: 99%

Radioactive Iodine-125 in Tumor Therapy: Advances and Future Directions

Wei

Mengyuan

et al. 2021

Front. Oncol.

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Radioactive iodine-125 (I-125) is the most widely used radioactive sealed source for interstitial permanent brachytherapy (BT). BT has the exceptional ability to deliver extremely high doses that external beam radiotherapy (EBRT) could never achieve within treated lesions, with the added benefit that doses drop off rapidly outside the target lesion by minimizing the exposure of uninvolved surrounding normal tissue. Spurred by multiple biological and technological advances, BT application has experienced substantial alteration over the past few decades. The procedure of I-125 radioactive seed implantation evolved from ultrasound guidance to computed tomography guidance. Compellingly, the creative introduction of 3D-printed individual templates, BT treatment planning systems, and artificial intelligence navigator systems remarkably increased the accuracy of I-125 BT and individualized I-125 ablative radiotherapy. Of note, utilizing I-125 to treat carcinoma in hollow cavity organs was enabled by the utility of self-expandable metal stents (SEMSs). Initially, I-125 BT was only used in the treatment of rare tumors. However, an increasing number of clinical trials upheld the efficacy and safety of I-125 BT in almost all tumors. Therefore, this study aims to summarize the recent advances of I-125 BT in cancer therapy, which cover experimental research to clinical investigations, including the development of novel techniques. This review also raises unanswered questions that may prompt future clinical trials and experimental work.

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Does Seed Migration Increase the Risk of Second Malignancies in Prostate Cancer Patients Treated With Iodine-125 Loose Seeds Brachytherapy?

Cited by 6 publications

References 20 publications

Extracranial 125I Seed Implantation Allows Non-invasive Stereotactic Radioablation of Hippocampal Adult Neurogenesis in Guinea Pigs

Extracranial 125I Seed Implantation Allows Non-invasive Stereotactic Radioablation of Hippocampal Adult Neurogenesis in Guinea Pigs

Analysis of outcomes after non-contour-based dose painting of dominant intra-epithelial lesion in intra-operative low-dose rate brachytherapy

Radioactive Iodine-125 in Tumor Therapy: Advances and Future Directions

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