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29.02.2016 | Original Article

Seed loss in prostate brachytherapy

Operator dependency and impact on dosimetry

verfasst von: Nancy El-Bared, M.D., Natanel Sebbag, Dominic Béliveau-Nadeau, M.Sc., Yannick Hervieux, M.Sc., Renée Larouche, M.Sc., Daniel Taussky, M.D., Guila Delouya, M.D., M.Sc.

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 5/2016

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Abstract

Introduction

The aim of our study was to review seed loss and its impact on dosimetry as well as the influence of the treating physician on seed loss and dosimetry in patients treated with prostate brachytherapy using permanent loose ¹²⁵I implant.

Patients and methods

We analyzed 1087 consecutive patients treated by two physicians between July 2005 and April 2015 at a single institution. Pelvic fluoroscopic imaging was done 30 days post implant and a chest X-ray when seed loss was observed.

Results

Seed loss occurred in 19.4 % of patients: in 20.0 % of implants done by the most experienced physician and in 17.2 % by the less experienced physician (p = 0.4) and migration to the thorax occurred in 5.9 % (6.9 vs. 2.2 %, p = 0.004). The mean seed loss rate was 0.57 % [standard deviation (SD) 1.39] and the mean rate of seeds in the thorax was 0.14 % (SD 0.65). The most experienced physician had a higher mean number of seeds lost: 0.36 versus 0.25 (p = 0.055), and a higher mean number of seed migration to the thorax: 0.1 versus 0.02 (p < 0.001). When at least one seed was lost, a decrease of 4.2 Gy (p < 0.001) in the D90 and a decrease of 3.5 % (p = 0.002) in the V150 was observed.

Conclusion

We found a significant decrease in V150 and D90 with the occurrence of seed loss. Furthermore, we found a difference in seed migration among the physicians demonstrating that seed loss is operator dependant.

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Titel: Seed loss in prostate brachytherapy
Operator dependency and impact on dosimetry
verfasst von: Nancy El-Bared, M.D.
Natanel Sebbag
Dominic Béliveau-Nadeau, M.Sc.
Yannick Hervieux, M.Sc.
Renée Larouche, M.Sc.
Daniel Taussky, M.D.
Guila Delouya, M.D., M.Sc.
Publikationsdatum: 29.02.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 5/2016
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-016-0961-4

Springer Medizin

Seed loss in prostate brachytherapy

Operator dependency and impact on dosimetry