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Published: 14 September 2024

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1

JARUSEVICIUS, Laimonas, Arturas INCIURA, Elona JUOZAITYTE, Kestutis VAICIUNAS, Antanas VAITKUS, and Migle SNIUREVICIUTE. "Comparison of Implant Quality between Loose and Intra-operatively Linked Iodine-125 Seeds in Prostate Cancer Brachytherapy." Journal of Radiation Research 53, no. 3 (2012): 439–46. http://dx.doi.org/10.1269/jrr.11064.

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2

Bieniek, E., H. Ashamalla, and A. Guirguis. "Determinants of prostate volume changes following iodine-125 interstitial prostate implant." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 15563. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.15563.

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15563 Purpose: Prostate brachytherapy (PB) has been linked with increase in prostate volume (PV). This study evaluates post- operative PV changes and the variables that might affect prostate swelling. Methods: Twenty four patients (pts) were analyzed. Twelve were treated with PB only, 8 with external beam radiation (EBRT) prior to implant, and 4 with EBRT after PB. Pre-treatment PSA and Gleason score ranges were 1.9–10.8 and 5–8 respectively. Pre- implant and post-implant day 1, 9, 30, and 60 (PV0, PV1, PV9, PV30, and PV60) measurements were done using computed tomography. Univariate analysis of PV change and the following was done: PV0, number of needles, seeds, and needle insertion attempts, seed activity (0.3 vs 0.5mCi), hormonal ablation therapy, and prior EBRT. Urinary symptoms were assessed using International Prostate Scoring System (IPSS). Results: Ninety six PV measurements were done by a single observer. PV0 ranged from 27.1 to 89.4 cc (mean 48.2). Largest PV was observed on day 1 (40.1–118.7, mean 67.1). Successive PV measurements afterwards continued to decrease. Mean PV values on day 9, 30, and 60 were 58.6, 51.5, and 42.3cc respectively. The differences between PV0 and all successive PV’s were statistically significant. Mean increase in PV1 from PV0 was 18.9±16.8cc (p<0.001), PV0 and PV9 9.7cc, PV0 and PV30 2.6cc. PV60 was smaller than PV0 by an average of 6.6cc. Statistically significant positive correlation was found between PV increase and seed activity (p=0.02) while treatment with EBRT prior to PB was associated with less prostate swelling (p=0.043). Other variables were not significantly correlated with PV changes. Although the mean IPSS score increased from pre-implant value of 9.2 to 13.7 on day 60, the differences between IPSS values were not statistically significant. Conclusions: Maximum prostate size is observed on the first day after implant. Prostate begins to decrease in size between day 1 and day 9 and reaches pre-procedure volume after day 30. Higher seed activity results in greater prostate swelling, while less brachytherapy- induced swelling is observed in patients treated with external radiation prior to implant. Resolution of prostate swelling does not appear to parallel with improvement in urinary symptoms in the first 2 months after implant. No significant financial relationships to disclose.

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3

Hirose, K., M. Aoki, M. Sato, H. Akimoto, Y. Hatayama, H. Kawaguchi, Y. Hashimoto, et al. "A Retrospective Analysis of the Relationship Between Prescribed Dose and Dosimetric Advantage Taken by Intraoperative Built Custom Linked Seeds in Iodine-125 Prostate Brachytherapy." International Journal of Radiation Oncology*Biology*Physics 96, no. 2 (October 2016): E254. http://dx.doi.org/10.1016/j.ijrobp.2016.06.1261.

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4

Chapet, Olivier, Edwige Rigal, Corina Udrescu, Abdeslam Hassouni, Alain Ruffion, and Vincent Piriou. "First experience of prostate brachytherapy under hypnosedation." Journal of Clinical Oncology 34, no. 2_suppl (January 10, 2016): 149. http://dx.doi.org/10.1200/jco.2016.34.2_suppl.149.

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149 Background: Hypnosedation is an alternative to general or spinal anesthesia and may reduce bleeding, postoperative recovery time, as well as potential side-effects of anesthesia. In our department, hypnosedation has been used for prostate brachytherapy (PBT). Levels of pain, comfort, anxiety and satisfaction were evaluated prospectively and are reported. Methods: Twenty-seven patients were treated with BT under hypnosedation. Anesthesia was limited to a perineal injection of 30cc of xylocaine. The same radiation-oncologist and the same anesthesiologist performed all the interventions and hypnosedations, respectively. A dose of 145Gy was delivered to the prostate using iodine-125 linked-seeds. In case of pain or discomfort during hypnosedation, the patient could ask to switch from hypnosedation to general anesthesia. Visual Analog Scales (VAS), from 0 to 10 points, were used to evaluated the lowest, mean and highest level of pain, comfort and anxiety. The VAS forms were completed by the patients in the same day (D1), before (anxiety and pain) and after the intervention (pain and comfort), and 8 weeks later (pain and comfort). Results: Only two patients had a general anesthesia, because they didn’t reach the hypnotic level and failed to follow the hypnosedation procedure. In the table below are presented the results (average and range) of the VAS scores for pain and comfort for the remaining 25 patients. Twenty-four (88.9%) patients would choose this approach again and recommend it to other patients. One patient would prefer a general anesthesia due to the discomfort of the position during the procedure (leg cramps). For all the patients, the short post-operative recovery time and their active participation to the treatment were two major advantages of the hypnosedation. Conclusions: To our knowledge, this is the first experience of brachytherapy under hypnosedation. Our first results demonstrate that hypnosedation is a feasible and comfortable alternative method to anesthesia, perfectly suitable for PBT. [Table: see text]

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5

Alberti, Winfried, Stephan Divoux, Bernhard Pothmann, Peter Tabor, Klaus-Peter Hermann, and Dietrich Harder. "Autoradiography for iodine-125 seeds." International Journal of Radiation Oncology*Biology*Physics 25, no. 5 (April 1993): 881–84. http://dx.doi.org/10.1016/0360-3016(93)90319-q.

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6

Rostelato, M. E., C. Zeituni, A. Feher, J. Moura, E. Moura, H. Nagatomi, J. Manzoli, C. Souza, and C. Silva. "146 poster: Iodine-125 Seeds - Brazillian Panel." Radiotherapy and Oncology 91 (May 2009): S52—S53. http://dx.doi.org/10.1016/s0167-8140(15)34403-0.

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7

Li, Yuliang, Wei Wang, Zhonghao Liu, Jingrun Zhu, Chuanwang Wu, Mingyang Liu, Yongzheng Wang, Wujie Wang, and Bin Liu. "Brachytherapy with iodine 125 seeds for bone metastases." Journal of Cancer Research and Therapeutics 13, no. 5 (2017): 742. http://dx.doi.org/10.4103/jcrt.jcrt_399_17.

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8

Tong, Yu-Suo, and Xiu-Feng Cao. "Brachytherapy with iodine-125 seeds for hepatocellular carcinoma." World Chinese Journal of Digestology 21, no. 29 (2013): 3072. http://dx.doi.org/10.11569/wcjd.v21.i29.3072.

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9

Zhang, Wanfu, and Kaiyuan Luo. "Migration of Radioactive Iodine-125 Seeds: Case Report." Indian Journal of Surgery 75, no. 4 (June 19, 2012): 263–64. http://dx.doi.org/10.1007/s12262-012-0604-7.

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10

Xiong, Liting, Yuhan Yang, Mengyuan Li, Ping Jiang, Chunxiao Li, and Junjie Wang. "Advancements and challenges in interstitial brachytherapy using iodine-125 seeds." Advances in Radiotherapy & Nuclear Medicine 1, no. 2 (October 3, 2023): 0914. http://dx.doi.org/10.36922/arnm.0914.

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Radiation therapy has been used for over a century in the treatment of tumors, with interstitial tissue treatment using radioactive seeds playing a key role in this approach. Iodine-125 (I-125) seeds are the most commonly used radioactive sealed source for permanent interstitial brachytherapy. In recent decades, significant advancements have been made in the field of interstitial radiation therapy. The development of three-dimensional (3D)-printed personalized templates, treatment planning systems, and robot-assisted systems have significantly improved the accuracy of I-125 brachytherapy. This review summarizes the advances in technology, radiobiology, physics, and immunology of I-125 brachytherapy. These advancements have improved the accuracy of dose delivery and increased the effectiveness of I-125 interstitial brachytherapy. In particular, the utilization of 3D-printed personalized templates has allowed for customized treatment planning and more precise dose delivery. Robot-assisted systems have also made significant contributions by assisting in the precise placement of radioactive seeds during treatment. However, several challenges persist within the field of interstitial I-125 brachytherapy. One of the current issues is the difficulty in accurately predicting the biological response to radiation therapy in individual patients. Addressing this challenge represents an important area for further research, as it has the potential to improve treatment outcomes and minimize side effects. In addition, there is a need for more research into the utilization of immunotherapy in conjunction with interstitial brachytherapy, as this combination has demonstrated promise in preclinical studies. Overall, this review provides a comprehensive overview of the advances and challenges associated with interstitial brachytherapy using I-125 seeds. These advancements offer a theoretical basis for achieving precise and remote medical care in brachytherapy. As technology continues to evolve, it is likely that interstitial brachytherapy will emerge as an even more effective treatment option for cancer patients.

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11

Anglesio, Silvia, Elisa Calamia, Christian Fiandra, Francesca Romana Giglioli, Riccardo Ragona, Umberto Ricardi, and Roberto Ropolo. "Prostate Brachytherapy with Iodine-125 Seeds: Radiation Protection Issues." Tumori Journal 91, no. 4 (July 2005): 335–38. http://dx.doi.org/10.1177/030089160509100410.

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Aims and background Brachytherapy for prostate cancer by means of permanently implanted 125 I sources is a well established procedure. An increasing number of patients all over the world are treated with this modality. When the technique was introduced at our institution, radiation protection issues relative to this technique were investigated in order to comply with international recommendations and national regulations. Particular attention was paid to the need for patient shielding after discharge from hospital. Methods The effective and equivalent doses to personnel related to implantation, the effective dose to patient relatives as computed by a developed algorithm, the air kerma strength values for the radioactive sources certified by the manufacturer compared with those measured by a well chamber, and the effectiveness of lead gloves in shielding the hands were evaluated. Results The effective dose to the bodies of personnel protected by a lead apron proved to be negligible. The mean equivalent doses to the physician's hands was 420 μSv for one implant; the technician's hands received 65 μSv. The mean air kerma rate measured at the anterior skin surface of the patient who had received an implant was 55 μGy/h (range, 10–115) and was negligible with lead protection. The measured and certified air kerma strength for 125I seeds in RAPID Strand corresponded within a margin of ± 5%. The measured attenuation by lead gloves in operative conditions was about 80%. We also defined the recommendations to be given to the patient at discharge. Conclusions The exposure risks related to brachytherapy with 125I to operators and public are limited. However, alternation of operators should be considered to minimize exposure. Patient-related measurements should verify the dose rate around the patient to evaluate the need for shielding and to define appropriate radiation protection recommendations.

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12

Moura, João Augusto, Carla Daruich de Souza, Maria Elisa Chuery Martins Rostelato, Eduardo Santana de Moura, Francisco Edmundo Sprenger, Hélio Rissey Nagatomi, Carlos Alberto Zeituni, Anselmo Feher, and José Eduardo Manzoli. "Leakage test methodology development in iodine-125 seeds production." Progress in Nuclear Energy 62 (January 2013): 79–82. http://dx.doi.org/10.1016/j.pnucene.2012.09.011.

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13

Knüfermann, H., M. Wannenmacher, and H. Sommerkamp. "Interstitial radiotherapie of prostate carcinomas with 125-iodine seeds." Journal of Cancer Research and Clinical Oncology 111, S1 (February 1986): S15. http://dx.doi.org/10.1007/bf02579831.

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14

Steinfeld, Alan D., Bernadine R. Donahue, and Leonard Plaine. "Pulmonary embolization of iodine-125 seeds following prostate implantation." Urology 37, no. 2 (February 1991): 149–50. http://dx.doi.org/10.1016/0090-4295(91)80212-p.

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15

Dawes, P. J. D. K., and E. G. A. Aird. "Preliminary experience with iodine-125 seeds in Newcastle upon Tyne." Clinical Radiology 36, no. 4 (January 1985): 359–64. http://dx.doi.org/10.1016/s0009-9260(85)80300-7.

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16

Ni, Qingtao, Chi Pan, Qing Guo, Peng Wang, Yan Yang, Wei Zhang, and Shengbin Dai. "A Case of Iodine 125 Seeds (I-125) Responding to Lung Squamous Cell Carcinoma." Dose-Response 20, no. 2 (April 2022): 155932582211033. http://dx.doi.org/10.1177/15593258221103373.

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Lung squamous cell cancer (SCC) and accounts for approximately 20%–30% of all lung cancers. Surgery, chemotherapy and radiotherapy are the main treatments for lung SCC patients. A case with lung SCC patient who was treated using iodine 125 seeds (I-125) because the location of the tumor was adjacent to the great vessels. I-125 is an ideal brachytherapy for lung SCC patients with large masses who lost the chance of operation. I-125 is an adjuvant therapy, combined with chemotherapy and molecular targeting therapy might serve to improve the prognosis of lung SCC patients.

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17

Narang, Subina, Awadesh K. Pandey, Gurbir Kaur, Mannat Giran, Sanjay K. Saxena, Sandeep Moudgil, Dinesh K. Walia, et al. "Iodine-125 brachytherapy for choroidal melanoma by using Ocuprosta seeds with indigenous non-collimated plaques: Our initial experience." Indian Journal of Ophthalmology 72, Suppl 1 (December 22, 2023): S90—S95. http://dx.doi.org/10.4103/ijo.ijo_1694_23.

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Purpose: Brachytherapy is the gold-standard treatment for choroidal melanoma. This study evaluated iodine-125 brachytherapy by using Ocuprosta seeds with indigenous non-collimated plaques in Asian patients. Methods: Retrospective single-center study in a tertiary care hospital of 12 eyes with choroidal melanoma in 12 Asian patients who underwent brachytherapy with Ocuprosta seeds fixed on non-collimated plaques and had a follow-up of at least 32 months (mean: 42.4 ± 9.5 months; median: 40 months). Radiotherapy was planned after developing the digital 3D model of the tumor within the eye by using radiological images and clinical pictures. Ocuprosta iodine-125 seeds were used on indigenous non-collimated gold plaques to deliver the radiation for precalculated time. “Successful outcome” was taken as a decrease in the volume of the tumor, and “unsuccessful outcome” was defined as no change in the tumor volume or increase in the tumor volume at 24 months after brachytherapy. Results: The mean decrease in tumor volume was 21% (914.5 ± 912.2 mm3 to 495.7 ± 633.6 mm3) after brachytherapy, which correlated with the baseline volume of the tumor. Ten eyes (83.3%) showed a reduction in tumor volume, whereas two eyes showed an increase in the volume of the tumor after brachytherapy. One of the cases with a reduction in tumor size developed neovascular glaucoma. Enucleation was done in three eyes. A globe salvage rate of 75% and tumor regression rate of 83% were seen in the present study using Ocuprosta seeds. Conclusions: Iodine-125 brachytherapy with uncollimated indigenous gold plaques is an effective treatment modality for choroidal melanomas in Asian patients.

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18

Kumar, Pradeep P., Roger R. Good, Angelo A. Patil, and Lyal G. Leibrock. "Permanent High-Activity Iodine-125 in the Management of Petroclival Meningiomas: Case Reports." Neurosurgery 25, no. 3 (September 1, 1989): 436–42. http://dx.doi.org/10.1227/00006123-198909000-00019.

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Abstract Two cases of petroclival meningiomas are reported wherein the tumors were completely destroyed without surgical resection or external-beam irradiation by means of permanent stereotactic implantation of one or two high-activity iodine-125 seeds.

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19

Otani, Yuki, Takahiro Yamada, Shingo Kato, Naoto Shikama, Kazuto Funakoshi, Isao Kuroda, Hodaka Numasaki, Takayuki Nose, Takushi Dokiya, and Masahiko Oguchi. "Source strength assay of iodine-125 seeds sealed within sterile packaging." Journal of Applied Clinical Medical Physics 14, no. 2 (March 2013): 253–63. http://dx.doi.org/10.1120/jacmp.v14i2.4082.

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20

Barquero Sanz, R., D. Antón García, D. de Miguel Pérez, J. de Frutos Baraja, P. Alonso Martínez, D. Alonso Hernández, A. del Castillo Belmonte, P. Diezhandino García, and F. López-lara Martín. "Release of patients after prostate implantation of iodine seeds (I-125)." Reports of Practical Oncology & Radiotherapy 18 (June 2013): S158—S159. http://dx.doi.org/10.1016/j.rpor.2013.03.052.

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21

Joyce, Frederic, Flemming Burcharth, Hans H. Holm, and Ivan Strøyer. "Ultrasonically guided percutaneous implantation of iodine-125 seeds in pancreatic carcinoma." International Journal of Radiation Oncology*Biology*Physics 19, no. 4 (October 1990): 1049–52. http://dx.doi.org/10.1016/0360-3016(90)90032-f.

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22

Liu, Bin, Tong Zhou, Junjie Wang, Fujun Zhang, and Yuliang Li. "Percutaneous CT-Guided Iodine-125 Seeds Implantation for Unresectable Pancreatic Cancer." Brachytherapy 15 (May 2016): S141. http://dx.doi.org/10.1016/j.brachy.2016.04.246.

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23

Gai, Baodong, Dongyan Yang, Qingchun Li, and Haishan Zhang. "Ultrasonically Guided Percutaneous Implantation of Iodine-125 Seeds in Pancreatic Carcinoma." Brachytherapy 16, no. 3 (May 2017): S90—S91. http://dx.doi.org/10.1016/j.brachy.2017.04.169.

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24

Xiao, Lianxiang, Zhenjia Li, Lebin Wu, Zengtao Sun, and Xianghong Yu. "Sequential Treatment of Superior Vena Cava Syndrome Caused by of Non-small Cell Carcinoma Lung Cancer (NSCLC) with Vascular Stenting and Iodine-125 Implantation." Technology in Cancer Research & Treatment 8, no. 4 (August 2009): 281–87. http://dx.doi.org/10.1177/153303460900800405.

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Feasibility and efficacy of sequentially performed endovascular stenting and Iodine-125 brachytherapy for malignant superior vena cava syndrome (SVCS) were evaluated. Thirty-four patients with malignant SVCS caused by NSCLC underwent sequential treatment of endovascular stenting and Iodine-125 brachytherapy. SVCS was diagnosed in all patients by CT images or vena-cavography. Pathology diagnosis was acquired by image guided biopsy. Endovascular stent placement was performed as first-line treatment for symptom relief. CT-guided Iodine-125 seed implantation performed 24hr after stenting. Clinical end points were resolution of symptoms and local efficacy of primary malignancy regression. Symptom relief rate was >90% after 24hr and 97% after 3 months. No migration of seeds or restenosis occurred in any patient. The local efficacy (defined as either partial or complete response) was 53%, 79%, 88% and 74% after 1, 3, 6 and 12months, respectively. Mean SVCS-free survival time was 305 days (range 120–960 days). Two patients were still alive at the time of this writing, Thirty-one died from progression and one died from acute heart disease. Sequentially performed endovascular stenting and Iodine-125 brachytherapy provides a safe and effective alternative for malignant SVCS caused by NSCLC.

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Yang, Chongshuang, Yunhua Xiao, Yexiang Du, Junru Xiong, Liangyu Deng, Qinghua Liang, Jing Yuan, Chuang He, Fengtian He, and Xuequan Huang. "Iodine-125 Seeds Inhibit Carcinogenesis of Hepatocellular Carcinoma Cells by Suppressing Epithelial-Mesenchymal Transition via TGF-β1/Smad Signaling." Disease Markers 2022 (May 7, 2022): 1–13. http://dx.doi.org/10.1155/2022/9230647.

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To investigate the radioactive iodine-125 (I-125) seed on migrating and invading of hepatocellular carcinoma (HCC) cells and its mechanism, the irradiation of PLC and Huh7 cells was carried out with I-125 seeds in vitro. Cell counting kit 8 assay was employed to measure cell viability. Cell migration was evaluated by using wound-healing assay. Cell invasion was detected by Transwell assay; RT-PCR and Western blot were used for the detection of the mRNA and proteins of TGF-β1 signaling pathway-related genes. The viability of PLC and Huh7 cells declined in a dose-dependent manner with increasing irradiation from 0 Gy, 2 Gy, 4 Gy, and 6 Gy, to 8 Gy, respectively. The IC50 of PLC and Huh7 cells were 6.20 Gy and 5.39 Gy, respectively, after 24 h of irradiation. Migration and invasion abilities of I-125 group cells were greatly weakened ( P < 0.05 ) comparing with the control group. According to the outcomes of RT-PCR and WB, I-125 seed irradiation significantly inhibited the mRNA and protein expression of N-cadherin, vimentin, TGF-β1, p-Smad2/3, and Snail. But the mRNA and protein expressions of E-cadherin were enhanced. Rescue experiment demonstrates that TGF-β1 activator could reverse the inhibitory effects of I-125 on invasion and migration of cells. The results of in vivo experiments further verified that the I-125 seeds can inhibit the proliferation and TGF-β1 of xenographed PLC cells. In conclusion, I-125 seeds restrain the invasion and migration of HCC cells by suppressing epithelial to mesenchymal transition, which may associate with the inhibition of the TGF-β1 signaling.

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26

Franca, Carlos A. S., Sergio L. Vieira, Antonio C. P. Carvalho, Antonio J. S. Bernabe, and Antonio B. R. Penna. "Radioactive seed migration after prostate brachytherapy with Iodine-125 using loose seeds versus stranded seeds." International braz j urol 35, no. 5 (October 2009): 573–80. http://dx.doi.org/10.1590/s1677-55382009000500009.

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27

Kumar, Pradeep P., Arun A. Patil, Lyal G. Leibrock, Wei-Kom Chu, Joseph Syh, Gayle F. McCaul, and Michael A. Reeves. "Brachytherapy: A Viable Alternative in the Management of Basal Meningiomas." Neurosurgery 29, no. 5 (November 1, 1991): 676–80. http://dx.doi.org/10.1227/00006123-199111000-00006.

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Abstract Thirteen patients with intracranial meningiomas of the skull base were treated with one or more high-activity iodine-125 seeds. In 11 patients, the seeds were implanted stereotactically under local anesthesia. A minimum dose of 100 to 500 Gy was delivered to the tumor at a dose rate of 5 to 25 cGy/h. Indications for this procedure included recurrence after initial surgery or as the primary modality of treatment in patients who were not candidates for surgery. All 13 patients are alive at a median follow-up of 15 months. Nine of 11 patients (82%) without calcification in their meningiomas achieved complete response. The remaining 4 patients-2 with calcification and 2 without-achieved partial response. No early or late complications were observed. We conclude from our experience that both recurrent and primary meningiomas of the skull base can be treated effectively with permanent iodine-125 brachytherapy.

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28

Lin, Junqing, Leye Yan, Xiaolong Wang, Zhengzhong Wu, Kun Ke, Xin Lin, Ning Huang, and Weizhu Yang. "Administration of Iodine-125 Seeds Promotes Apoptosis in Cholangiocarcinoma through the PI3K/Akt Pathway." Advances in Polymer Technology 2022 (February 24, 2022): 1–6. http://dx.doi.org/10.1155/2022/6934934.

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Purpose. We aimed to examine the effects of 125I seeds on the gene expression of Bcl-2, Bax, and PI3K/Akt pathway components in cholangiocarcinoma cells. Methods. In vitro, human cholangiocarcinoma RBE cells were treated with 125I seeds (0.39 mCi or 0.85 mCi) for 72 h, 120 h, and 168 h. Cell proliferation and apoptosis were assessed. The expression of Bcl-2 and Bax was detected by RT-PCR, and Western blotting was carried out to explore changes in Akt activity. Result. 125I seeds inhibited the proliferation of RBE cells. The apoptosis rate of the RBE cells in the low-activity group was significantly higher than that in the high-activity group at 120 h and 168 h, while no difference was found between the two groups at 72 h. After 120 h of culture, the gene expression of Bcl-2 and Bax decreased in both groups, the ratio of Bcl − 2 / Bax in the low-activity group decreased, and the PI3K/Akt signaling pathway was inhibited in both groups. Conclusion. 125I seeds affect the proliferation and apoptosis of cholangiocarcinoma cells in a dose-dependent manner. The therapeutic effect of low-activity 125I seeds on cancer cells may be better. 125I seed brachytherapy may promote the apoptosis of cholangiocarcinoma cells by inhibiting the PI3K/Akt signaling pathway and regulating the Bcl − 2 / Bax ratio.

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29

Brun, Thomas, Gwenael Ferron, Thomas Filleron, Jacques Bonnet, Alejandra Martinez, Anne Ducassou, Fabien Corbiere, and Martine Delannes. "Experimental study of pelvic perioperative brachytherapy with iodine 125 seeds (I-125) in an animal model." Journal of Contemporary Brachytherapy 10, no. 5 (2018): 463–69. http://dx.doi.org/10.5114/jcb.2018.79470.

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30

Li, Y., B. Liu, T. Zhou, J. Geng, F. Zhang, and J. Wang. "Percutaneous computed tomography-guided iodine-125 seeds implantation for unresectable pancreatic cancer." Indian Journal of Cancer 52, no. 6 (2015): 69. http://dx.doi.org/10.4103/0019-509x.172517.

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31

Leite, Elton Trigo Teixeira, João Luis Fernandes da Silva, Eduardo Capelletti, Cecilia Maria Kalil Haddad, and Gustavo Nader Marta. "Prostate brachytherapy with iodine-125 seeds: analysis of a single institutional cohort." International braz j urol 45, no. 2 (April 2019): 288–98. http://dx.doi.org/10.1590/s1677-5538.ibju.2018.0142.

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32

Arsenali, Bruno, Kenneth G. A. Gilhuijs, Max A. Viergever, and Hugo W. A. M. de Jong. "Optimization of Parallel-Hole Collimators for Intraoperative Localization of Iodine-125 Seeds." IEEE Transactions on Nuclear Science 63, no. 5 (October 2016): 2527–32. http://dx.doi.org/10.1109/tns.2016.2572958.

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33

Guo, Y., Y. Liu, Z. Li, D. Wang, Y. Du, J. Chen, and Z. Jin. "EUS-guided implantation of radioactive iodine-125 seeds in retroperitoneal metastatic adenocarcinoma." Endoscopy 41, S 02 (November 2009): E301. http://dx.doi.org/10.1055/s-0029-1214499.

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34

Sabater Marco, Vicente, Sandra Barberá Bosch, and Núria Santonja López. "Iodine-125 seeds in prostatic transurethral resection: Differential diagnosis with schistosome eggs." Revista Española de Patología 52, no. 1 (January 2019): 54–56. http://dx.doi.org/10.1016/j.patol.2018.02.002.

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35

Knüfermann, H., M. Wannenmacher, and H. Sommerkamp. "Interstitial radiotherapy with 125-iodine seeds in the treatment of prostate carcinomas." Journal of Cancer Research and Clinical Oncology 111, S1 (February 1986): S142. http://dx.doi.org/10.1007/bf02580336.

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36

Kleefeld, Christoph, Anysja Zuchora, Louise Fahy, and Margaret Moore. "Review of nine years of a 125-Iodine seeds prostate brachytherapy programme." Physica Medica 32, no. 7 (July 2016): 953. http://dx.doi.org/10.1016/j.ejmp.2016.05.027.

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REED, D., A. MUELLER, K. WALLNER, E. FORD, and G. MERRICK. "Rapid strand™ vs. loose (iodine-125 seeds): A prospective randomized trial." International Journal of Radiation OncologyBiologyPhysics 60 (September 2004): S461. http://dx.doi.org/10.1016/s0360-3016(04)02066-8.

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Reed, D. R., A. Mueller, K. Wallner, E. Ford, and G. Merrick. "Rapid strand™ vs. loose (iodine-125 seeds): A prospective randomized trial." International Journal of Radiation Oncology*Biology*Physics 60, no. 1 (September 2004): S461. http://dx.doi.org/10.1016/j.ijrobp.2004.07.679.

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Yamaguchi, Takahiro, Masayuki Matsuo, Takayuki Mori, Yoshifumi Noda, Chiyoko Makita, Fuminori Hyodo, Koji Iinuma, Masahiro Nakano, Takuya Koie, and Hidekazu Tanaka. "Seed Density as a New Predictive Index of Seed Migration in Brachytherapy for Prostate Cancer Using Iodine-125 Loose Seed." Current Oncology 30, no. 4 (April 4, 2023): 4060–66. http://dx.doi.org/10.3390/curroncol30040308.

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Aim: This study aimed to examine the usefulness of seed density as a predictor of seed migration in patients with prostate cancer who received brachytherapy using Iodine-125 loose seed. Methods: From May 2006 to April 2016, 320 patients with localized prostate cancer underwent transperineal brachytherapy using iodine-125 loose seeds. Among them, 202 (63.1%) patients received brachytherapy monotherapy and 118 (36.9%) received combined brachytherapy and external beam radiotherapy. Seed density was calculated using the following formula: seed density = implanted seed number/prostate volume. All patients underwent radiography of the chest, abdomen and pelvis, and computed tomography at 1 day, 1 month, and 1 year after brachytherapy to evaluate the presence of seed migration. Results: In total, the number of implanted seeds was 21,876. Seed migration was detected in 92 (28.8%) patients. Of a total of 21,876 seeds, 144 (0.66%) showed migration. The number of needles, number of seeds, and seed density were significantly higher in the group with migration than in the group without migration (p = 0.05). The ROC cutoff values for prostate volume, number of needles, number of seeds, and seed density were 20.9 cc, 21, 65, and 3.0, respectively. In the univariate analysis, prostate volume, number of needles, number of seeds, seed density, and treatment modality were all significant factors in predicting migration (p = 0.05). In the multivariate analysis, seed density and treatment modality were significant factors in predicting migration (p = 0.05). Conclusion: Seed density is useful for predicting seed migration. In cases with seed density > 3.0, it is necessary to take measures such as considering the use of stranded seeds.

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Brahimaj, Bledi, Michael Lamba, John C. Breneman, and Ronald E. Warnick. "Iodine-125 seed migration within brain parenchyma after brachytherapy for brain metastasis: case report." Journal of Neurosurgery 125, no. 5 (November 2016): 1167–70. http://dx.doi.org/10.3171/2015.11.jns151464.

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This case report documents the migration of 3 iodine-125 (125I) seeds from the tumor resection cavity into brain parenchyma over a 7-year period. A 66-year-old woman had a history of metastatic ovarian carcinoma, nickel allergy, and reaction to a titanium hip implant that required reoperation for hardware removal. In this unique case of parenchymal migration, the seed paths seemed to follow white matter tracts, traveling between 18.5 and 35.5 mm from the initial implant site. The patient's initial neurological decline, which was thought to be related to radiation necrosis, appeared to stabilize with medical therapy. She subsequently developed progressive right hemispheric edema that resulted in neurological deterioration and death. Considering her previous reactions to nickel and titanium, the authors now speculate that her later clinical course reflected an allergic reaction to the titanium casing of the 125I seeds. Containing a trace amount of nickel, 125I seeds can elicit a delayed hypersensitivity reaction in patients with a history of nickel dermatitis. Preoperative patch testing is recommended in these patients, and 125I seed implantation should be avoided in those who test positive.

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Zhou, Chuanguo, Hui Li, Qiang Huang, Jianfeng Wang, and Kun Gao. "Biliary self-expandable metallic stent combined with Iodine-125 seeds strand in the treatment of hilar malignant biliary obstruction." Journal of International Medical Research 48, no. 4 (December 29, 2019): 030006051988784. http://dx.doi.org/10.1177/0300060519887843.

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Objective To assess the safety and effectiveness of a self-expandable metallic stent (SEMS) combined with Iodine-125 seeds strand to treat hilar malignant biliary obstruction (MBO). Methods This retrospective study included patients who had received SEMS with 125I seeds strand (seeds group) or SEMS alone (controls) to treat hilar MBO. Demographic, biochemical, stent patency, overall survival and complications data were extracted and analysed. Results A total of 76 patients were included (seeds group, n = 40; controls, n = 36), with a total of 608 seeds deployed in the seeds group (mean, 15.2 ± 4.1 [range, 8–25] seeds per patient). Statistically significant between-group differences were shown in median stent patency time (seeds group, 387.0 ± 27.9 days [95% confidence interval {CI} 332.4, 441.6] versus controls, 121.0 ± 9.1 days [95% CI 103.2, 138.8]) and in median overall survival (seeds group, 177.0 ± 17.9 days [95% CI 141.8, 212.2] versus controls, 123.0 ± 20.4 [95% CI 83.0, 163.0]). There were no statistically significant between-group differences in complication rates. Conclusion SEMS combined with 125I seeds strand is safe, feasible, and tolerable in treating patients with hilar MBO, and may be effective in prolonging stent patency time and overall survival.

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Valizadeh, Shahrzad, Elham Saeedzadeh, Alireza Zali, Hasanali Nedaei, and Saeed Zare Ganjaroodi. "Stereotactic Iodine-125 Brachytherapy for Low-Grade Glioma Treatment: A Monte Carlo study." International Clinical Neuroscience Journal 9, no. 1 (February 6, 2022): e9-e9. http://dx.doi.org/10.34172/icnj.2022.09.

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Background: Stereotactic brachytherapy is an appropriate method that has been used for brain tumors and metastases treatment for more than 40 years for many patients in the world. Also, iodine-125 brachytherapy has been utilized in brain tumors for interstitial brachytherapy treatment since 1979. Even though the physical and biological features make these implants particularly attractive for minimal invasive treatment, the main goal of this paper is to evaluate the I-125 seed time and dose reached to brain glioma tumors of different sizes for treatment using Monte Carlo modeling. Methods: In this paper, Monte Carlo simulation has been applied by the Gate code with 20 (MBq) activity for an iodine seed design for low-grade glioma tumors treatment. Dosimetry features of this source were defined by the updated TG-43U1 recommendations. The absorbed dose distribution around the seed was calculated using the Gate code in liquid water. Result: The ideal condition for brachytherapy is for tumors smaller than 4 cm. With a larger tumor size, the absorption dose at the border of tumor and healthy tissue will be decreased and the implantation time for seeds will increase. Conclusion: Placing an iodine-125 source inside the tumor is not sufficient because of the non-uniform dose distribution in the tumor and the length of treatment time. Using four iodine-125 sources eliminates the tumor, and also, a uniform dose distribution is created in the tumor and the implantation time will be reduced, respectively.

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Kumar, Pradeep P., Roger R. Good, F. Miles Skultety, and Lyal G. Leibrock. "Local Control of Recurrent Clival and Sacral Chordoma after Interstitial Irradiation with Iodine-125: New Techniques for Treatment of Recurrent or Unresectable Chordomas." Neurosurgery 22, no. 3 (March 1, 1988): 479–83. http://dx.doi.org/10.1227/00006123-198803000-00005.

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Abstract Using new 125I brachytherapy techniques, we were able to deliver safely a tumor volume dose of 16,000 rads to a previous irradiated, large, recurrent sacral chordoma by means of the intraoperative interstitial implantation of 229 low activity 125I seeds and 40,000 rads to a previously irradiated, small, recurrent clival chordoma by means of the transnasal needle implantation of two high activity 125I seeds. Iodine-125 brachytherapy was followed by regression of tumor, lessening of symptoms, and bony recalcification in both cases. (Neurosurgery 22:479-483, 1988)

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Chen, Chao, Wei Wang, Wujie Wang, Yongzheng Wang, Zhe Yu, and Yuliang Li. "Locally advanced pancreatic carcinoma with jaundice: the benefit of a sequential treatment with stenting followed by CT-guided 125I seeds implantation." European Radiology 31, no. 9 (February 25, 2021): 6500–6510. http://dx.doi.org/10.1007/s00330-021-07764-6.

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Abstract Objectives To evaluate the role of sequential therapy with percutaneous biliary stenting and CT-guided iodine-125 seed implantation for locally advanced pancreatic carcinoma with concomitant obstructive jaundice. Methods Between January 2016 and December 2018, 42 patients diagnosed with locally advanced pancreatic carcinoma with concomitant obstructive jaundice were enrolled retrospectively. All patients received biliary stenting via percutaneous transhepatic biliary drainage (PTBD) to alleviate obstructive jaundice. Thereafter, twenty-two patients underwent CT-guided iodine-125 seed implantation (treatment group), and 20 did not (control group). The prescribed dose in the treatment group was 110–130 Gy. The clinical data, duration of biliary stent patency, and overall survival (OS) were evaluated. Results Overall, the total bilirubin level decreased from 275.89 ± 115.44 to 43.08 ± 43.35 μmol/L (p < 0.001) 1 month after percutaneous biliary stenting. In the treatment group, the postoperative median dose covering 90% of the target volume was 129.71 Gy. Compared with the control group, the treatment group had a long mean duration of biliary stent patency and median OS (11.42 vs. 8.57 months, p < 0.01; 11.67 vs. 9.40 months, p < 0.01, respectively). The overall positive response rates 6 months post-treatment in the treatment and control groups were 72.7% (16/22) and 30% (6/20), respectively. Adverse events of more than grade 3 were not observed during the follow-up. Conclusion Sequential therapy with percutaneous biliary stenting and CT-guided iodine-125 seed implantation is an effective and safe treatment alternative for locally advanced pancreatic carcinoma with concomitant obstructive jaundice, which is worthy of clinical application. Key Points • Obstructive jaundice was alleviated after biliary stent placement in all patients, and the total bilirubin level decreased. • The overall positive response rates at 6 months post-treatment were higher in the treatment group than in the control group, and adverse events of more than grade 3 were not observed during the follow-up period. • Sequential therapy with percutaneous biliary stenting and CT-guided iodine-125 seed implantation can prolong biliary stent patency and improve survival.

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Sider, Lee, Bharat B. Mittal, Albert A. Nemcek, and Vidya S. Bobba. "CT-Guided Placement of Iodine-125 Seeds for Unresectable Carcinoma of the Lung." Journal of Computer Assisted Tomography 12, no. 3 (May 1988): 515–17. http://dx.doi.org/10.1097/00004728-198805000-00035.

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Sider, Lee, Bharat B. Mittal, Albert A. Nemcek, and Vidya S. Bobba. "CT-Guided Placement of Iodine-125 Seeds for Unresectable Carcinoma of the Lung." Journal of Computer Assisted Tomography 12, no. 3 (May 1988): 515–19. http://dx.doi.org/10.1097/00004728-198805010-00035.

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47

Beydoun, Nadine, Joseph A. Bucci, Yaw S. Chin, and David Malouf. "Iodine-125 thin seeds decrease prostate swelling during transperineal interstitial permanent prostate brachytherapy." Journal of Medical Imaging and Radiation Oncology 58, no. 1 (July 19, 2013): 109–16. http://dx.doi.org/10.1111/1754-9485.12102.

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de Souza, C. Daruich, M. Chuery Martins Rostelato, C. Zeituini, J. Moura, F. Rodrigues de Mattos, F. dos Santos Peleias, E. Santana de Moura, A. Feher, and O. da Costa. "SU-E-T-356: Brachytherapy Iodine-125 Seeds: New Laboratory Developed in Brazil." Medical Physics 40, no. 6Part16 (June 2013): 286. http://dx.doi.org/10.1118/1.4814790.

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Jinna, Li, Liu Jingjia, Wang Hao, Qu Ang, Wang Junjie, and Zhao Yong. "The Anti-Tumor Effects of Iodine-125 Radioactive Seeds Radiation in Nasopharyngeal Carcinoma." Brachytherapy 13 (March 2014): S108. http://dx.doi.org/10.1016/j.brachy.2014.02.401.

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Schiefer, Hans, Friedrich von Toggenburg, Wolf Seelentag, Ludwig Plasswilm, Gerhard Ries, Cornelius Lenggenhager, Hans-Peter Schmid, et al. "Exposure of Treating Physician to Radiation during Prostate Brachytherapy Using Iodine-125 Seeds." Strahlentherapie und Onkologie 185, no. 10 (October 2009): 689–95. http://dx.doi.org/10.1007/s00066-009-1990-z.

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