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Interpretation of adverse reactions and complications in Chinese expert consensus of Iodine-125 brachytherapy for pancreatic cancer.
Li, Q, Liang, Y, Zhao, Y, Gai, B
Journal of cancer research and therapeutics. 2019;(4):751-754
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Owing to the location of the pancreas and its complex anatomical relationship, it is difficult to perform radioactive Iodine-125 seed implantation in patients with pancreatic cancer as it can cause surgical side effects and further complications. To standardize the procedure of radioactive Iodine-125 seed implantation in the treatment of pancreatic cancer and reduce the occurrence of adverse reactions and complications during and after operation, the Chinese Medical Doctor Association of Radioactive Seed Implantation Technology Expert Committee, Committee of Minimally Invasive Therapy in Oncology, Chinese Anti-Cancer Association, and the Radioactive Seed Therapy Branch organized and helped establish an expert consensus in China regarding radioactive Iodine-125 seed implantation in the treatment of pancreatic cancer. This article aims at interpreting the adverse reactions and complications after the implantation of radioactive seeds.
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Iodine-125 seed implantation for synchronous pancreatic metastases from hepatocellular carcinoma: A case report and literature review.
Xiong, J, Kwong Chian, S, Li, J, Liu, X
Medicine. 2017;(46):e8726
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RATIONALE The image-guided iodine-125 seed implantation has been widely used for a variety of tumors, including prostatic cancer, pulmonary cancer, hepatocellular carcinoma and pancreatic cancer. However, the clinical value of iodine-125 seed implantation for the treatment of pancreatic metastasis from hepatocellular carcinoma has not been reported. We presented the first case with ultrasound-guided iodine-125 seed implantation for this disease. PATIENT CONCERNS We presented the case of a 48-year-old man patient with primary hepatocellular carcinoma and pancreatic metastasis who was managed with ultrasound-guided iodine-125 seeds implantation. DIAGNOSES She was diagnosed with synchronous pancreatic metastases from hepatocellular carcinoma. INTERVENTIONS Puncture biopsy and ultrasound-guided iodine-125 seeds implantation. OUTCOMES The hepatic and pancreatic tumors were obviously reduced after 15 months. Moreover, the liver function test was mildly abnormal in glutamic-oxalacetic transaminase and glutamic-pyruvic transaminase. LESSONS The image-guided iodine-125 seeds implantation was an important therapeutic approache to unresectable hepatocellular carcinoma with pancreatic metastasis. However, more related cases should be reported for further evaluating the value of the way.
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Expert consensus workshop report: Guideline for three-dimensional printing template-assisted computed tomography-guided 125I seeds interstitial implantation brachytherapy.
Wang, J, Zhang, F, Guo, J, Chai, S, Zheng, G, Zhang, K, Liao, A, Jiang, P, Jiang, Y, Ji, Z
Journal of cancer research and therapeutics. 2017;(4):607-612
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Radioactive 125I seeds (RIS) interstitial implantation brachytherapy has been a first-line treatment for early-stage cancer of the prostate gland. However, its poor accuracy and homogeneity has limited its indication and hampered its popularization for a long time. Intriguingly, scholars based in China introduced computed tomography (CT)-guided technology to improve the accuracy and homogeneity of RIS implantation and broadened the indications. Then, they creatively designed and introduced three-dimensional printing coplanar template (3D-PCT) and 3D printing noncoplanar template (3D-PNCT) into the practice of RIS implantation. Use of such templates makes RIS implantation more precise and efficacious and aids preoperative planning, real-time dose optimization, and postoperative planning. However, studies on the standard workflow for 3D-PT-assisted CT-guided RIS implantation have not been published. Therefore, the China Northern Radioactive Seeds Brachytherapy Group organized multidisciplinary experts to formulate the guideline for this emerging treatment modality. This guideline aims at standardizing 3D-PT-assisted CT-guided RIS implantation procedures and criteria for selecting treatment candidates and assessing outcomes and for preventing and managing postoperative complications.
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Focal salvage therapy for local prostate cancer recurrences after primary radiotherapy: a comprehensive review.
Duijzentkunst, DA, Peters, M, van der Voort van Zyp, JR, Moerland, MA, van Vulpen, M
World journal of urology. 2016;(11):1521-1531
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BACKGROUND/AIM: Patients with locally recurrent prostate cancer after primary radiotherapy can be eligible for salvage treatment. Whole-gland salvage techniques carry a high risk of toxicity. A focal salvage approach might reduce the risk of adverse events while maintaining cancer control in carefully selected patients. The aim of this review was to evaluate current literature to assess whether focal salvage leads to a comparable or favourable recurrence rate and less toxicity compared to whole-gland salvage. METHODS A literature search was performed using PubMed, Embase and the Cochrane Library. A total of 3015 articles were screened and assessed for quality. Eight papers [on focal cryoablation (n = 3), brachytherapy (n = 3) and high-intensity focused ultrasound (n = 2)] were used to report outcomes. RESULTS One-, 2-, 3- and 5-year biochemical disease-free survival (BDFS) ranges for focal salvage are, respectively, 69-100, 49-100, 50-91 and 46.5-54.5 %. Severe genitourinary, gastrointestinal and sexual function toxicity rates are 0-33.3 %. One study directly compares focal to whole-gland salvage cryotherapy, showing 5-year BDFS of, respectively, 54.4 and 86.5 % with lower toxicity rates for focal salvage patients. CONCLUSION Provisional data suggest that BDFS rates of focal salvage are in line with those of whole-gland approaches. There is evidence that focal salvage could decrease severe toxicity and preserve erectile function.
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Mesonephric adenocarcinoma of the vagina : Diagnosis and multimodal treatment of a rare tumor and analysis of worldwide experience.
Mueller, I, Kametriser, G, Jacobs, VR, Bogner, G, Staudach, A, Koch, H, Wolfrum-Ristau, P, Schausberger, C, Fischer, T, Sedlmayer, F
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]. 2016;(9):668-71
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BACKGROUND Mesonephric adenocarcinoma of the vagina is an extremely rare tumor of the female genital tract, with only a few cases reported so far worldwide. Consequently, there is no established standard treatment and limited knowledge about the prognosis and biologic behavior of vaginal mesonephric adenocarcinoma. METHODS This report documents a new case of vaginal mesonephric adenocarcinoma diagnosed in a 54-year-old woman, and analyzes this in the context of all previously published cases. RESULTS MRI demonstrated that the 2.5 × 1.8 cm tumor of the vaginal wall was invading urethra and bladder. Following surgical excision, histologic analysis determined mesonephric adenocarcinoma of the vagina, stage pT2 R1. In order to avoid the mutilating extended surgery which would be required to reach R0 and considerable impairment of quality of life, adjuvant radiochemotherapy was administered with external radiation and brachytherapy, including 5 cycles of cisplatin (40 mg/m²) for radiosensitization. After 4 years of continuous oncologic follow-up, the patient is alive and clinically free of disease. CONCLUSION In this case it was shown that adjuvant radiochemotherapy with radiation and brachytherapy was effective to manage the surgical R1 situation and maintain the patient's life quality. More published cases reports are needed to gradually substantiate optimal treatment strategies.
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Iodine-125 brachytherapy for brain tumours--a review.
Schwarz, SB, Thon, N, Nikolajek, K, Niyazi, M, Tonn, JC, Belka, C, Kreth, FW
Radiation oncology (London, England). 2012;:30
Abstract
Iodine-125 brachytherapy has been applied to brain tumours since 1979. Even though the physical and biological characteristics make these implants particularly attractive for minimal invasive treatment, the place for stereotactic brachytherapy is still poorly defined.An extensive review of the literature has been performed, especially concerning indications, results and complications. Iodine-125 seeds have been implanted in astrocytomas I-III, glioblastomas, metastases and several other tumour entities. Outcome data given in the literature are summarized. Complications are rare in carefully selected patients.All in all, for highly selected patients with newly diagnosed or recurrent primary or metastatic tumours, this method provides encouraging survival rates with relatively low complication rates and a good quality of life.
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[Physical and handling properties of I-125 seed source].
Hanada, T
Nihon Hoshasen Gijutsu Gakkai zasshi. 2009;(4):476-81
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Modern brachytherapy for treatment of prostate cancer.
Heysek, RV
Cancer control : journal of the Moffitt Cancer Center. 2007;(3):238-43
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BACKGROUND Prostate cancer is the most common cancer diagnosed in men. An increasing number of these patients are seeking minimally invasive procedures such as transperineal interstitial permanent radioactive seed prostate brachytherapy. METHODS This paper reviews the historical perspective and the current advances in transperineal interstitial permanent radioactive seed prostate brachytherapy. The 10- to 15-year results data now published for brachytherapy alone or in combination with external-beam irradiation are also reviewed. RESULTS Modern brachytherapy using transperineal interstitial permanent radioactive seed prostate brachytherapy offers patients an excellent quality of life with convenient outpatient treatment with long-term (10- to 15-year) biochemical relapse-free survival rates ranging from 67% to 87%, depending on risk stratification. CONCLUSIONS Modern-day brachytherapy utilizing either radioactive iodine-125 or palladium-103 alone or in combination with supplemental external-beam treatment offers patients a successful treatment outcome with acceptable toxicity.
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The impact of technological advances on the evolution of 3D conformal brachytherapy for early prostate cancer.
Nori, D, Reddy, NM, Vaughan, ED, Shemtov, MM
Technology in cancer research & treatment. 2004;(4):335-45
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Permanent implantation of I-125 and Pd-103 seeds is one of the widely used treatment options for the early stage prostate cancer with minimum normal tissue complications and long-term local control of the tumor. This is possible because of several technological advances made in the past decade to better understand the procedural aspects of implantations with the desired clinical outcome and with acceptable morbidities. In addition, with the widespread use of PSA testing, more widely disseminated information about prostate cancer and increased patient awareness, over 70% of patients are diagnosed early with localized disease and therefore are candidates for definitive local therapy. Delineation of soft tissue structures including the prostate, rectum, urethra and bladder has become more accurate with the use of imaging modalities including Ultrasound and MRI, with or without the CT. A re-evaluation of the dosimetric parameters of the radioactive sources has lead to a more precise estimate of the dose delivered to the prostate and the associated critical normal structures. Technological improvements in the post implant dosimetry have helped to understand the factors, which makes an implant a "good implant" or a "poor implant". Intraoperative treatment planning with on line dosimetry is emerging as one of the best approaches for prostate brachytherapy. In addition, better software is now available producing dose-volume histograms with 3D target and normal tissue reconstruction. The combination of seed implant followed by IMRT would provide scope for differentially boosting the regions under-dosed because of uncontrollable and unexpected reasons during the implant and unsuspected micro extensions of the tumor.
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Permanent prostate brachytherapy: lessons learned, lessons to learn.
Potters, L
Oncology (Williston Park, N.Y.). 2000;(7):981-91; discussion 991-2, 997-9
Abstract
Current techniques for permanent prostate brachytherapy are associated with excellent biochemical control in patients with localized prostate cancer. Data now available confirm 5- to 10-year results with this treatment modality that are comparable to those with external-beam irradiation or radical prostatectomy. Nonetheless, treatment protocols and techniques for prostate brachytherapy vary from center to center. Controversy exists regarding the selection of patients for brachytherapy alone or in combination with external-beam irradiation. The role of neoadjuvant androgen deprivation also remains undefined in patients with localized prostate cancer. Matched-pair analysis studies performed at Memorial Sloan-Kettering Cancer Center have examined the role of isotope selection, the addition of external-beam irradiation, and the use of neoadjuvant androgen deprivation. These studies provide insights into the use of permanent brachytherapy in patients with localized prostate cancer. In addition, postimplant dosimetry needs to be a requirement for centers performing seed implants. Data now appear to support specific computed tomography-based criteria to evaluate implant quality and delivered dose to the prostate. Unfortunately, prostate edema and poor imaging techniques limit the evaluation of implant dosimetry. Treatment planning techniques that utilize new imaging modalities, coupled with computerized treatment planning, may help improve the implant procedure and dosimetry.