Department of Radiology, Keio University School of Medicine, Tokyo, Japan.
Radiat Oncol. 2011 Oct 5;6:130. doi: 10.1186/1748-717X-6-130.
The aim was to determine the incidence of seed migration not only to the chest, but also to the abdomen and pelvis after transperineal interstitial prostate brachytherapy with loose (125)I seeds.
We reviewed the records of 267 patients who underwent prostate brachytherapy with loose (125)I seeds. After seed implantation, orthogonal chest radiographs, an abdominal radiograph, and a pelvic radiograph were undertaken routinely to document the occurrence and sites of seed migration. The incidence of seed migration to the chest, abdomen, and pelvis was calculated. All patients who had seed migration to the abdomen and pelvis subsequently underwent a computed tomography scan to identify the exact location of the migrated seeds. Postimplant dosimetric analysis was undertaken, and dosimetric results were compared between patients with and without seed migration.
A total of 19,236 seeds were implanted in 267 patients. Overall, 91 of 19,236 (0.47%) seeds migrated in 66 of 267 (24.7%) patients. Sixty-nine (0.36%) seeds migrated to the chest in 54 (20.2%) patients. Seven (0.036%) seeds migrated to the abdomen in six (2.2%) patients. Fifteen (0.078%) seeds migrated to the pelvis in 15 (5.6%) patients. Seed migration occurred predominantly within two weeks after seed implantation. None of the 66 patients had symptoms related to the migrated seeds. Postimplant prostate D90 was not significantly different between patients with and without seed migration.
We showed the incidence of seed migration to the chest, abdomen and pelvis. Seed migration did not have a significant effect on postimplant prostate D90.
本研究旨在确定经会阴间隙前列腺近距离治疗后，除胸部外，种植的放射性粒子是否会迁移至腹部和骨盆。
我们回顾了 267 例行游离 125I 前列腺近距离治疗患者的病历。种植后常规行正位胸片、腹部平片和骨盆平片以记录种植粒子的位置和迁移情况。计算胸部、腹部和骨盆种植粒子的迁移发生率。所有发生腹部和骨盆种植粒子迁移的患者均行 CT 以明确迁移粒子的确切位置。对所有患者进行种植后剂量学分析，并比较有和无种植粒子迁移患者的剂量学结果。
267 例患者共植入 19236 枚种植粒子。共有 91 枚（0.47%）种植粒子发生迁移，其中 66 例（24.7%）患者共 69 枚（0.36%）粒子迁移至胸部，54 例（20.2%）患者 69 枚（0.36%）粒子迁移至腹部，15 例（5.6%）患者 15 枚（0.078%）粒子迁移至骨盆。粒子迁移多发生于种植后 2 周内。66 例发生粒子迁移的患者均无与迁移粒子相关的症状。有和无粒子迁移患者的前列腺 D90 无显著差异。
本研究报道了游离 125I 前列腺近距离治疗后种植粒子向胸部、腹部和骨盆的迁移发生率，粒子迁移并未显著影响前列腺 D90。
