Nakiri Makoto, Ogasawara Naoyuki, Kurose Hirofumi, Ueda Kosuke, Suekane Hiroki, Chikui Katsuaki, Nishihara Kiyoaki, Uemura Keiichiro, Ejima Kazuhisa, Hoshino Ryuji, Onishi Satoshi, Komiya Keisuke, Muraki Koichiro, Hattori Chikayuki, Ogo Etsuyo, Ishitake Tatsuya, Igawa Tsukasa
Department of Urology, Kurume University School of Medicine, Kurume, Japan.
Department of Radiology, Kurume University School of Medicine, Kurume, Japan.
J Contemp Brachytherapy. 2024 Oct;16(5):315-322. doi: 10.5114/jcb.2024.144175. Epub 2024 Oct 16.
Displacement minimization of seeds is crucial during surgery in brachytherapy; however, only a few reports have compared the operability of different seeds. TheraStrand-SL is a seed, in which TheraAGX100 is wrapped in polyglactin 910 thread, and intra-prostatic displacement is expected to be reduced compared with that of Thera-AGX100, owing to the complex shape of TheraStrand-SL. We conducted a prospective study on the operability and treatment outcomes of TheraAGX100 and TheraStrand-SL placement by a single operator.
The study included 69 patients who received brachytherapy for prostate cancer. Endpoints were comparisons of intra- and post-treatment dose-volume histograms, seed displacement incidence rate, seed displacement distance, seed migration/dropout incidence rate, and adverse events incidence rate between TheraAGX100 ( = 25) and TheraStrand-SL ( = 44) groups.
The intra-prostatic displacement incidence rate was significantly lower in the TheraStrand-SL group than in the TheraAGX100 group (TheraAGX100 group: 96.0%; TheraStrand-SL group: 11.4%). Further, the intra-prostatic displacement count per case tended to be lower in the TheraStrand-SL group than in the TheraAGX100 group. Additionally, a comparison of displacement distance per case showed that the TheraStrand-SL group (2.01 mm) had a statistically significantly shorter distance than the TheraAGX100 group (9.22 mm). No significant differences between the two groups were observed in terms of migration, explanted dropout seed count, dose-volume histograms, and adverse events incidence rate.
Our study demonstrated the usefulness of TheraStrand-SL against intra-prostatic displacement. We expect TheraStrand-SL to have further applications in brachytherapy, including focal therapy.
在近距离放射治疗手术中，种子源的位移最小化至关重要；然而，只有少数报告比较了不同种子源的可操作性。TheraStrand-SL是一种种子源，其中TheraAGX100包裹在聚乙醇酸910线中，由于TheraStrand-SL的复杂形状，预计与Thera-AGX100相比，前列腺内位移会减少。我们对由一名操作者进行的TheraAGX100和TheraStrand-SL植入的可操作性和治疗结果进行了一项前瞻性研究。
该研究纳入了69例接受前列腺癌近距离放射治疗的患者。终点指标是比较TheraAGX100组（n = 25）和TheraStrand-SL组（n = 44）治疗期间及治疗后的剂量体积直方图、种子源位移发生率、种子源位移距离、种子源迁移/脱落发生率以及不良事件发生率。
TheraStrand-SL组的前列腺内位移发生率显著低于TheraAGX100组（TheraAGX100组：96.0%；TheraStrand-SL组：11.4%）。此外，TheraStrand-SL组每例的前列腺内位移计数往往低于TheraAGX100组。另外，对每例位移距离的比较显示，TheraStrand-SL组（2.毫米）的距离在统计学上显著短于TheraAGX100组（9.22毫米）。两组在迁移、取出的脱落种子计数、剂量体积直方图和不良事件发生率方面未观察到显著差异。
我们的研究证明了TheraStrand-SL在防止前列腺内位移方面的有效性。我们预计TheraStrand-SL在近距离放射治疗中，包括局部治疗，会有进一步的应用。
