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Brachytherapy with permanent seed implantation.

Shiro Saito¹, Hirohiko Nagata, Michio Kosugi

¹Department of Urology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan. ssaito@ntmc.hosp.go.jp

International Journal of Clinical Oncology

|December 12, 2007

Summary

Permanent seed brachytherapy for prostate cancer, using iodine-125 seeds, is now approved in Japan. This effective, minimally invasive treatment offers low morbidity and is becoming more common following strict guidelines and training.

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Area of Science:

Oncology
Radiation Oncology
Medical Physics

Background:

Permanent interstitial brachytherapy with iodine-125 (I-125) or palladium-103 (Pd-103) seeds is a widely adopted treatment for localized prostate cancer in the United States, often replacing radical prostatectomy due to high efficacy and low morbidity.
Japan's strict radiation safety laws previously prevented the use of permanent seed implantation, despite its established benefits.
Following extensive discussions, permanent interstitial brachytherapy with I-125 was approved in Japan in July 2003, with specific institutional guidelines.

Purpose of the Study:

To report the approval and initial implementation of permanent interstitial brachytherapy with iodine-125 (I-125) for prostate cancer in Japan.
To highlight the efforts undertaken to ensure quality, safety, and improved clinical outcomes for this new treatment modality in Japan.
To project the increasing adoption and impact of brachytherapy for prostate cancer in Japan.

Main Methods:

The study describes the regulatory approval process and the subsequent implementation of I-125 brachytherapy in Japan.
It mentions the establishment of guidelines and restrictions for participating institutions.
Ongoing quality improvement initiatives include medical conferences, technical training, and multi-institutional clinical studies.

Main Results:

Permanent interstitial brachytherapy with I-125 was approved in Japan in July 2003.
Over 70 institutions initiated the treatment by June 2007.
Quality assurance measures, including training and studies, are actively being conducted nationwide.

Conclusions:

Permanent interstitial brachytherapy with I-125 represents a significant advancement in prostate cancer treatment in Japan.
The treatment is expected to become more prevalent due to its efficacy, minimally invasive nature, and low morbidity.
Continuous quality improvement efforts are crucial for optimizing clinical outcomes and radiation safety.