You have accessJournal of UrologyProstate Cancer: Localized V1 Apr 20121124 PREDICTION AND CLINICAL IMPLICATION OF SEED MIGRATION AFTER BRACHYTHERAPY WITH I-125 FREE SEEDS IN PATIENTS WITH LOCALIZED PROSTATE CANCER Jun Nakashima, Akitomo Sugawara, Hirohiko Nagata, Ryuichi Mizuno, Naoyuki Shigematsu, Mototsugu Oya, and Masaaki Tachibana Jun NakashimaJun Nakashima Tokyo, Japan More articles by this author , Akitomo SugawaraAkitomo Sugawara Tokyo, Japan More articles by this author , Hirohiko NagataHirohiko Nagata Tokyo, Japan More articles by this author , Ryuichi MizunoRyuichi Mizuno Tokyo, Japan More articles by this author , Naoyuki ShigematsuNaoyuki Shigematsu Tokyo, Japan More articles by this author , Mototsugu OyaMototsugu Oya Tokyo, Japan More articles by this author , and Masaaki TachibanaMasaaki Tachibana Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1233AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The present study was undertaken to determine the clinical implication and predictors of seed migration after prostate brachytherapy using I-125 free seeds. METHODS The present study includes 267 patients with localized prostate cancer who underwent brachytherapy using I-125 free seeds as monotherapy. Seed migration was assessed by follow-up radiographs after brachytherapy. Univariate and multivariate analyses were performed to identify predictors of seed migration. Postimplant dosimetric results were compared between patients with seed migration and those without. RESULTS Overall, 91 of a total of 19,236 (0.47%) seeds migrated in 66 (25%) of 267 patients. Sixty-nine (0.36%) seeds migrated to the chest in 54 (20%) 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. All these 66 patients had no symptoms related to the migrated seeds. The postimplant prostate D90 value was not significantly different between patients with seed migration and those without (175.1±2.3 Gy vs. 175.0±1.5 Gy, p=0.992). The preoperative prostate volume estimated by TRUS (26±1 vs 22±1.0), the number of needles (28±1 vs 25±1), and the number of seeds implanted (78±2 vs 69±1) were significantly greater in patients with seed migration than in those without. There were no significant differences in patient age, PSA, and operating time between patients with and without seed migration. The presence of pubic arch interference (PAI) was associated significantly with seed migration (50% with PAI vs 19% without PAI) but neoadjuvant hormonal therapy and Gleason score were not. Stepwise logistic regression analysis for the prediction of seed migration showed that the number of seeds implanted and the presence of PAI were significant independent predictors. A nomogram for the prediction of seed migration is constructed and the probability for seed migration can be estimated (Figure). CONCLUSIONS Seed migration was not rare and did not have a significant effect on the postimplant prostate dosimetry. The number of seeds implanted and the presence or absence of PAI provide the most predictive information on seed migration. The combination of these two factors can be used to predict the risk of seed migration. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e455-e456 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jun Nakashima Tokyo, Japan More articles by this author Akitomo Sugawara Tokyo, Japan More articles by this author Hirohiko Nagata Tokyo, Japan More articles by this author Ryuichi Mizuno Tokyo, Japan More articles by this author Naoyuki Shigematsu Tokyo, Japan More articles by this author Mototsugu Oya Tokyo, Japan More articles by this author Masaaki Tachibana Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...