Late seed migration after prostate brachytherapy with Iod-125 permanent implants
Philipp Maletzki1, Christoph Schwab1, Patrick Markart1
1Department of Urology, St. Gallen Cantonal Hospital, St. Gallen, Switzerland.
Prostate International
|June 21, 2018
Summary
Late seed migration after prostate brachytherapy is common, occurring in 6% of patients over 3 years post-implantation. These migrations were asymptomatic and had no therapeutic consequences, though long-term follow-up is recommended.
Area of Science:
- Urology
- Radiation Oncology
- Medical Imaging
Background:
- Seed migration is a known complication following low dose rate brachytherapy for prostate cancer.
- While early migration is often assessed, data on late seed migration (beyond 3 years) is limited.
- This study investigates the incidence, location, symptoms, and treatment implications of late seed migration.
Purpose of the Study:
- To evaluate the incidence of late seed migration after prostate brachytherapy.
- To determine the anatomical sites of late seed migration.
- To assess the symptoms and therapeutic consequences of late seed migration.
Main Methods:
- Retrospective analysis of 63 patients undergoing transrectal ultrasound-guided, transperineal low dose rate brachytherapy for prostate cancer (2001-2010).
- Radiological assessment included pelvic X-rays and CT/MRI scans post-implantation and late follow-up (≥3 years) including chest X-ray.
- Distinction made between seed loss and migration into different anatomical regions.
Main Results:
- Seed loss was observed in 57% of patients up to 3 years post-brachytherapy.
- Late seed migration (≥3 years) occurred in 6% of patients with migration to the pelvis, lung, and liver.
- All identified late seed migrations were asymptomatic and required no therapeutic intervention.
Conclusions:
- Seed migration, particularly late migration, is a frequent finding after prostate brachytherapy and appears to be asymptomatic.
- Long-term radiological follow-up may be beneficial for detecting rare complications associated with prostate brachytherapy seeds.
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