Treatment of Cancer of Prostate by Interstitial Injection of Au 198: Studies in Problem of Distribution

Flocks, R.H.; Elkins, H.B.; Gulp, D.A.

doi:10.1016/s0022-5347(17)66592-3

Cited by 9 publications

(4 citation statements)

References 3 publications

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“…In liver tumors with a diameter of 2 to 8.8 cm, small (0.1–0.3 ml) volumes were used per location with a total maximum of 1.0–1.5 ml per treatment session [ 13 ]. Results obtained from non-particle intratumoral radionuclide therapies showed that larger volumes were associated with more side effects [ 46 , 47 ]. In prostate cancer, 20–50 ml (equal to the prostate volume) was injected, which resulted in 55 adverse events like strictures, fistulas, and ulcers in the first 100 patients.…”

Section: Resultsmentioning

confidence: 99%

“…In the subsequent 87 patients, only 2–3 ml injection fluid was used, and only eight events occurred. [ 46 ].…”

Section: Resultsmentioning

confidence: 99%

“…Theoretically, more fluid results in more propelling force and a more homogeneous distribution of microparticles in the target tissue. This should be balanced against the chances of more side effects [ 46 , 47 ]. The injected volume should probably range between 7 and 30% of the tumor volume [ 14 , 16 ] as excessive volume or pressure may result in leakage [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

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Intratumoral treatment with radioactive beta-emitting microparticles: a systematic review

et al. 2017

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PurposeThe purpose of this study was to review the role of radioactive microparticles (1–100 μm) for the treatment of solid tumors and provide a comprehensive overview of the feasibility, safety, and efficacy.MethodsA systematic search was performed in MEDLINE, EMBASE, and The Cochrane Library (January 2017) by combining synonyms for the determinants “tumor,” “injection,” and “radionuclide.” Data on injection technique, toxicity, tumor response, and survival were collected.ResultsThe search yielded 7271 studies, and 37 were included for analysis. Twelve studies were performed in human patients and 25 animal studies. The studies were heterogeneous in patient population, tumors, follow-up time, and treatment characteristics. The direct intratumoral injection of radioactive microparticles resulted in a response rate of 71% in a variety of tumors and uncomplicated procedures with high cumulative doses of >19,000 Gy were reported.ConclusionThe large variety of particles, techniques, and treated tumors in the studies provided an important insight into issues concerning efficacy, safety, particle and isotope choice, and other concepts for future research. Animal studies showed efficacy and a dose response. Most studies in humans concluded that intratumoral treatment with radioactive beta-emitting microparticles is relatively safe and effective. Conflicting evidence about safety and efficacy might be explained by the considerable variation in the treatment characteristics. Larger particles had a better retention which resulted in higher anti-tumor effect. Leakage seems to follow the path of least resistance depending on anatomical structures. Subsequently, a grid-like injection procedure with small volume depots is advised over a single large infusion. Controlled image-guided treatment is necessary because inadequate local delivery and inhomogeneous dose distribution result in reduced treatment efficacy and in potential complications.

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Section: Resultsmentioning

confidence: 99%

“…In the subsequent 87 patients, only 2–3 ml injection fluid was used, and only eight events occurred. [ 46 ].…”

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Intratumoral treatment with radioactive beta-emitting microparticles: a systematic review

et al. 2017

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“…After the first 100 cases, the pace of Flocks' work increased and by 1957, he had performed 389 total cases [5]. He reported again that the most challenging issue in his technique was adequate distribution of the radioactive gold throughout the prostate.…”

Section: The Evolution Of Flocks' Colloidal Gold Treatmentmentioning

confidence: 99%

Rubin H. Flocks and Colloidal Gold Treatments for Prostate Cancer

Rosevear

Lightfoot

O’Donnell

et al. 2011

The Scientific World JOURNAL

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In the early 1950s, Rubin H. Flocks of the University of Iowa began to treat prostate cancer patients with colloidal gold (Au198) therapy, evolving his technique over nearly 25 years in 1515 patients. We reviewed the long-term outcomes of Flocks' prostate cancer patients as compared to those patients treated by other methods at the University of Iowa before Flocks' chairmanship. We reviewed archived patient records, Flocks' published data, and long-term survival data from the Iowa Tumor Registry to determine short- and long-term outcomes of Flocks' work with colloidal gold. We also reviewed the literature of Flocks’ time to compare his outcomes against those of his contemporaries. The use of colloidal gold, either as primary or adjunctive therapy, provided short- and long-term survival benefit for the majority of Flocks' patients as compared to historical treatment options (p < 0.001). Flocks' use of colloidal gold for the treatment of locally advanced prostate cancer offered short- and long-term survival benefits compared to other contemporary treatments.

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The “Golden Age” of prostate brachytherapy: A cautionary tale

Aronowitz

2008

Brachytherapy

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Treatment of Cancer of Prostate by Interstitial Injection of Au 198: Studies in Problem of Distribution

Cited by 9 publications

References 3 publications

Intratumoral treatment with radioactive beta-emitting microparticles: a systematic review

Intratumoral treatment with radioactive beta-emitting microparticles: a systematic review

Rubin H. Flocks and Colloidal Gold Treatments for Prostate Cancer

The “Golden Age” of prostate brachytherapy: A cautionary tale

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