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Kojima T, Kawamura S, Otani Y, Hanada T, Wakitani Y, Naniwa K, Yorozu A, Ikushima H, Dokiya T. Current status and issues with the dosimetric assay of iodine-125 seed sources at medical facilities in Japan: a questionnaire-based survey†. JOURNAL OF RADIATION RESEARCH 2023; 64:962-966. [PMID: 37697653 PMCID: PMC10665308 DOI: 10.1093/jrr/rrad063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 07/13/2023] [Indexed: 09/13/2023]
Abstract
In conducting dosimetric assays of seed sources containing iodine-125 (125I), several major guidelines require the medical physicist to verify the source strength before patient treatment. Japanese guidelines do not mandate dosimetric assays at medical facilities, but since 2017, three incidents have occurred in Japan wherein seeds with incorrect strengths were delivered to medical facilities. Therefore, this study aimed to survey the current situation and any barriers to conducting the dosimetric assay of iodine-125 seeds at medical facilities in Japan. We conducted a questionnaire-based survey from December 2020 to April 2021, to examine whether seed assay and verification of the number of seeds delivered were being performed. We found that only 9 facilities (16%) performed seed assay and 28 (52%) verified the number of seeds. None of the facilities used an assay method that ensured traceability. The reasons for not performing an assay were divided into two categories: lack of resources and legal issues. Lack of resources included lack of instruments, lack of knowledge of assay methods, shorthand, or all of the above, whereas legal issues included the inability to resterilize iodine-125 seeds distributed in Japan and/or purchase seeds dedicated to the assay. Dosimetric assays, including simple methods, are effective in detecting calibration date errors and non-radioactive seeds. The study findings suggest that familiarization of medical personnel with these assay methods and investigation of the associated costs of labor and equipment should be recommended, as these measures will lead to medical reimbursement for quality assurance.
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Affiliation(s)
- Toru Kojima
- Department of Radiation Oncology, Saitama Prefectural Cancer Center, 780 Komuro, Ina-machi, Saitama 362-0806, Japan
| | - Shinji Kawamura
- Department of Radiological Technology, Graduate School of Health Sciences, Teikyo-Univercity, 6-22 Misaki-machi, Omuta, Fukuoka 836-8505, Japan
| | - Yuki Otani
- Department of Radiology, Kaizuka City Hospital, 3-10-20 Hori, Kaizuka, Osaka 597-0015, Japan
| | - Takashi Hanada
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Yuichiro Wakitani
- Japan Radioisotope Association, 2-28-45 Hon-komagome, Bunkyo-ku, Tokyo 113-8941, Japan
| | - Kenta Naniwa
- Chiyoda Technol Corporation, 1-7-12 Yushima, Bunkyo-ku, Tokyo 113-8681, Japan
| | - Atsunori Yorozu
- Department of Radiology, National Hospital Organization Tokyo Medical Center, 2-5-1, Higashigaoka, Meguro-ku, Tokyo 152-8902, Japan
| | - Hitoshi Ikushima
- Department of Therapeutic Radiology, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan
| | - Takushi Dokiya
- The Japan Foundation for Prostate Research, 2-9-3 Higashi-Shimbashi, Minato-ku, Tokyo 105-0021, Japan
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Li X, Shan L, Wang Q, Zhai H, Xuan Y, Yan G. Comparison of chronic gastrointestinal and genitourinary toxicities between brachytherapy and external beam radiotherapy for patients with prostate cancer: A systematic review and meta-analysis. Technol Health Care 2023; 31:357-372. [PMID: 37066936 DOI: 10.3233/thc-236031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
BACKGROUND 125I BT is an effective radiotherapy for prostate cancer. However, comparison data of GI and GU toxicities between BT, BT + EBRT, and EBRT-alone patient groups is limited. OBJECTIVE To define the GI and GU toxicities in prostate cancer to prevent adverse events after treatment. METHODS We searched published studies in PubMed, Cochrane, and Embase databases up to December 31, 2022. The endpoints were the RRs of GI and GU toxicities. Pooled data were assessed using a random-effects model. RESULTS Fifteen eligible studies were included into this analysis. LDR-BT had significantly lower RRs than LDR-BT + EBRT for acute GI (2.13; 95% CI, 1.22-3.69; P= 0.007) and late GI toxicities (3.96; 95% CI, 1.23-12.70; P= 0.02). Moreover, EBRT had significantly higher RRs than LDR-BT for acute GU (2.32; 95% CI, 1.29-4.15; P= 0.005) and late GU toxicities (2.38; 95% CI, 1.27-4.44; P= 0.007). HDR-BT had significantly higher RRs for acute GU toxicities than LDR-BT alone (0.30; 95% CI, 0.23-0.40; P< 0.00001). CONCLUSION The results implied that BT with and without EBRT can result in both GI and GU toxicities in patients with prostate cancer, with LDR-BT leading to a poorer urinary function than EBRT.
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Affiliation(s)
- Xuanzhe Li
- Department of Nuclear Medicine, Hospital of Haicang, Xiamen, Fujian, China
- Department of Nuclear Medicine, Hospital of Haicang, Xiamen, Fujian, China
| | - Ligang Shan
- Department of Anesthesiology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China
- Department of Nuclear Medicine, Hospital of Haicang, Xiamen, Fujian, China
| | - Qianqi Wang
- Department of Radiology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China
| | - Huige Zhai
- Department of Radiology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China
| | - Yinghua Xuan
- Department of Basic Medicine, Xiamen Medical College, Xiamen, Fujian, China
| | - Gen Yan
- Department of Radiology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, China
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Zhang J, Sun Q, Gao L, Sun L, Wang C, Li B, Wang J, Wang P. A multicenter prospective study on quality of life and pain relief for cancer patient after 125I seed implantation. Asia Pac J Oncol Nurs 2022; 9:100065. [PMID: 35634133 PMCID: PMC9131158 DOI: 10.1016/j.apjon.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 02/20/2022] [Accepted: 04/05/2022] [Indexed: 11/25/2022] Open
Abstract
Objective To prospectively explore the efficacy of 125I seed implantation on quality of life and pain relief in cancer patient. Methods Consecutive cancer patients who underwent 125I seed implantation in three centers in China between October 1, 2020 and March 31, 2021, were assessed. The Functional Assessment of Cancer Therapy and Brief Pain Inventory were used to evaluate patients' quality of life and pain relief on the day before, 1 week, 1 month, and 3 months after seed implantation. Results A total of 104 cancer patients were enroled. Total score of quality of life was not statistically different 3 months after seed implantation compared with before implantation, while patients' quality of life was worse one week after seed implantation but then recovered. A total of 43 (41.3%) patients had pain before seed implantation, of which 16 (37.2%) patients had severe pain and 27 (62.8%) had mild-to-moderate pain. In patients with severe pain, the worst pain scores decreased significantly 3 months after implantation. In patients with mild-to-moderate pain, pain severity and pain interference score increased significantly after implantation compared with pre-implantation. Compared with pain before implantation, patients' quality of life of patients without pain was higher. Conclusions 125I seed implantation maintains the quality of life of patients within 3 months. For patients with severe pain, seed implantation has obvious pain relief, which improves the quality of life of the patients. Nurses should provide personalized guidance for patients with different degrees of pain.
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Affiliation(s)
- Jingxuan Zhang
- Radiation Oncology Department, Peking University Third Hospital, Beijing, China
| | - Qiuyu Sun
- Radiation Oncology Department, Peking University Third Hospital, Beijing, China
| | - Lan Gao
- Interventional and Vascular Surgery Department, Southeast University Zhongda Hospital, Nanjing, China
| | - Lijuan Sun
- Oncology Department, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China
| | - Chunxue Wang
- Interventional and Vascular Surgery Department, Southeast University Zhongda Hospital, Nanjing, China
| | - Baohua Li
- Neurology Department, Peking University Third Hospital, Beijing, China
| | - Junjie Wang
- Radiation Oncology Department, Peking University Third Hospital, Beijing, China
| | - Panfeng Wang
- Radiation Oncology Department, Peking University Third Hospital, Beijing, China
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Ogawa S, Hasegawa A, Makabe S, Onagi A, Matsuoka K, Kayama E, Koguchi T, Hata J, Sato Y, Akaihata H, Kataoka M, Haga N, Kojima Y. Impacts of Neoadjuvant Hormonal Therapy Prior to Robot-Assisted Radical Prostatectomy on Postoperative Hormonal- and Sexual-Related Quality of Life – Assessment by Patient-Reported Questionnaire. Res Rep Urol 2022; 14:39-48. [PMID: 35223660 PMCID: PMC8865904 DOI: 10.2147/rru.s342063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 02/02/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Neoadjuvant hormonal therapy (HT) before radical prostatectomy (RP) is not recommended by current guidelines in terms of oncological outcomes. Despite this, neoadjuvant HT is sometimes conducted before RP for a small proportion of patients in clinical practice. This study evaluated the impacts of neoadjuvant HT on hormonal- and sexual-related quality of life (QOL) among patients who underwent robot-assisted RP (RARP). Materials and Methods Participants comprised 470 patients divided into a non-neoadjuvant HT group (n = 408) and a neoadjuvant HT group (n = 62). Hormonal- and sexual-related QOL were measured using the Expanded Prostate Cancer Index Composite (EPIC) questionnaire. Results Hormonal summary scores at 6 and 9 months, function scores before and 3, 6, and 9 months and bother score at 6 months after RARP were significantly lower in the neoadjuvant HT group than in the non-neoadjuvant HT group. Sexual function scores were decreased in the neoadjuvant HT group compared to the non-neoadjuvant HT group before and 6 months after RARP. In the neoadjuvant HT group, sexual function at 3 months after RARP was significantly worse in patients with >5 months of neoadjuvant HT than in patients with ≤5 months of neoadjuvant HT. Conversely, sexual bother at 3 months after RARP was significantly worse in patients with ≤5 months of neoadjuvant HT than in patients with >5 months of neoadjuvant HT. Conclusion Vintage neoadjuvant HT prior to RARP should not be recommended due to not only oncological outcomes, but also the impacts on postoperative hormonal- and sexual-related QOL.
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Affiliation(s)
- Soichiro Ogawa
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
- Correspondence: Soichiro Ogawa, Department of Urology, Fukushima Medical University School of Medicine, 1, Hikarigaoka, Fukushima, 960-1295, Japan, Tel +81 24 547 1316, Fax +81 24 548 3393, Email
| | - Akihisa Hasegawa
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Shunta Makabe
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akifumi Onagi
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Kanako Matsuoka
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Emina Kayama
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tomoyuki Koguchi
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Junya Hata
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yuichi Sato
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hidenori Akaihata
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masao Kataoka
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Nobuhiro Haga
- Department of Urology, Fukuoka University Faculty of Medicine, Fukuoka, Japan
| | - Yoshiyuki Kojima
- Department of Urology, Fukushima Medical University School of Medicine, Fukushima, Japan
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Palumbo C, Bruni A, Antonelli A, Artibani W, Bassi P, Bertoni F, Borghetti P, Bracarda S, Cicchetti A, Corvò R, Gacci M, Ingrosso G, Magrini SM, Maruzzo M, Mirone V, Montironi R, Muto G, Noale M, Porreca A, Russi E, Triggiani L, Tubaro A, Valdagni R, Maggi S, Conti GN. Health-related quality of life 24 months after prostate cancer diagnosis: an update from the Pros-IT CNR prospective observational study. Minerva Urol Nephrol 2021; 74:11-20. [PMID: 33439570 DOI: 10.23736/s2724-6051.20.04032-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND This study analyzes patient health-related quality of life (QoL) 24-month after prostate cancer (PCa) diagnosis within the PROState cancer monitoring in ITaly from the National Research Council (Pros-IT CNR) study. METHODS Pros-IT CNR is an ongoing, longitudinal and observational study, considering a convenience sample of patients enrolled at PCa diagnosis and followed at 6, 12, 24, 36, 48 and 60 months from the diagnosis. Patients were grouped according to the treatment received: nerve sparing radical prostatectomy (NSRP), non-nerve sparing radical prostatectomy (NNSRP), radiotherapy (RT), RT plus androgen deprivation (RT plus ADT) and active surveillance (AS). QoL was measured through the Italian versions of SF-12 and UCLA-PCI questionnaires at diagnosis and at 6-12 and 24-month. The minimal clinically important difference (MCID) was defined as half a standard deviation of the baseline domain. RESULTS Overall, 1537 patients were included in the study. The decline in urinary function exceeded the MCID at each timepoint only in the NSRP and NNSRP groups (at 24 months -14.7, P<0.001 and -19.7, P<0.001, respectively). The decline in bowel function exceeded the MCID only in the RT (-9.1, P=0.02) and RT plus ADT groups at 12 months (-10.3, P=0.001); after 24 months, most patients seem to recover their bowel complaints. The decline in sexual function exceeded the MCID at each timepoint in the NNSRP, NSRP and RT plus ADT groups (at 6 months -28.7, P<0.001, -37.8, P<0.001, -20.4, P<0.001, respectively). CONCLUSIONS Although all the treatments were relatively well-tolerated over the 24 month period following PCa diagnosis, each had a different impact on QoL.
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Affiliation(s)
- Carlotta Palumbo
- Department of Urology, Maggiore della Carità Hospital, Novara, Italy
| | - Alessio Bruni
- Unit of Radiotherapy, University Hospital of Modena, Modena, Italy
| | | | | | - Pierfrancesco Bassi
- Department of Urology, IRCCS A. Gemelli University Polyclinic Foundation, Sacred Heart Catholic University, Rome, Italy
| | - Filippo Bertoni
- Prostate Group of the Italian Association for Radiation Oncology (AIRO), Milan, Italy
| | - Paolo Borghetti
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | | | | | - Renzo Corvò
- Department of Radiation Oncology, IRCCS San Martino University Hospital, University of Genoa, Genoa, Italy
| | - Mauro Gacci
- Department of Urologic Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Gianluca Ingrosso
- Section of Radiation Oncology, Department of Surgical and Biomedical Science, University of Perugia, Perugia, Italy
| | - Stefano M Magrini
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | - Marco Maruzzo
- Medical Oncology Unit 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Vincenzo Mirone
- Department of Urology, University of Naples Federico II, Naples, Italy
| | - Rodolfo Montironi
- Section of Pathological Anatomy, School of Medicine, United Hospitals, Polytechnic University of the Marche Region, Ancona, Italy
| | - Giovanni Muto
- Department of Urology, Humanitas Gradenigo University Hospital, Turin, Italy
| | - Marianna Noale
- National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy -
| | - Angelo Porreca
- Department of Robotic Urological Surgery, Abano Terme Hospital, Abano Terme, Italy
| | - Elvio Russi
- Department of Radiotherapy, S. Croce e Carle Teaching Hospital, Cuneo, Italy
| | - Luca Triggiani
- Department of Radiation Oncology, University and Spedali Civili Hospital, Brescia, Italy
| | - Andrea Tubaro
- Unit of Urology, Sant'Andrea Hospital, La Sapienza University of Rome, Rome, Italy
| | | | - Stefania Maggi
- National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy
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Peigne C, Fournier G, Dissaux G, Delage F, Coquet JB, Boussion N, Goasduff G, Malhaire JP, Pradier O, Schick U, Valeri A. Minimal channel GreenLight photovaporization before permanent implant prostate brachytherapy for patients with obstructive symptoms: Technically feasible and safe. Brachytherapy 2020; 20:50-57. [PMID: 32891570 DOI: 10.1016/j.brachy.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Brachytherapy (BrT) is a standard treatment for low-risk to favorable-intermediate-risk prostate cancer but is a relative contraindication for patients with obstructive symptoms. We aimed to assess the feasibility and urinary toxicity of a minimal photovaporization (mPVP) before implantation. MATERIALS AND METHODS Between 04/2009 and 08/2016, 50 patients candidates for BrT but with International Prostate Symptom Score (IPSS)>15, uroflowmetry <15 mL/s, obstructive prostate or large median lobe underwent a mPVP (GreenLight Laser) at least 6 weeks (median 8.5) before permanent seed implantation (loose seeds, 125I, 160 Gy). RESULTS Two patients (4%) did not have sufficient improvement and did not undergo BrT, although it would have been possible at 3 months. For the 48 (96%) other patients, at the baseline, mean IPSS was 15.5 (±5.3), vs. 8.6 (±4.4) after mPVP (p = 1 × 10-6), and uroflowmetry 11.7 mL/s (±4), vs. 17.4 (±5.4) (p = 1.4 × 10-5). We did not experience any difficulty for BrT. Mean IPSS did not significantly increase 1, 3, or 6 months after BrT. With a median followup of 60 months [30-120], (92% assessed at last followup), only 4 patients (4/48 = 8.3%) experienced urinary retention and 5 (10.4%) needed surgery for urinary toxicity. In addition, only 2 patients (4%) needed medical treatment at last followup. Considering the 8 patients with de novo incontinence at 1 year, only 2 (4%) had persistent mild symptoms at last followup (36 months) (ICS1-2). CONCLUSIONS These results suggest that a two-step approach with an mPVP at least 6 weeks before BrT is feasible, with no excessive urinary toxicity, and may be a good strategy for obstructive patients seeking BrT.
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Affiliation(s)
| | - Georges Fournier
- Urology Department, CHU, Brest, France; Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France; LaTIM, INSERM, UMR 1101, Université de Bretagne Occidentale, Brest, France; CeRePP, Paris, France
| | | | | | | | - Nicolas Boussion
- LaTIM, INSERM, UMR 1101, Université de Bretagne Occidentale, Brest, France; Radiation Oncology Department, CHU, Brest, France
| | | | | | - Olivier Pradier
- Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France; LaTIM, INSERM, UMR 1101, Université de Bretagne Occidentale, Brest, France; Radiation Oncology Department, CHU, Brest, France
| | - Ulrike Schick
- Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France; LaTIM, INSERM, UMR 1101, Université de Bretagne Occidentale, Brest, France; Radiation Oncology Department, CHU, Brest, France
| | - Antoine Valeri
- Urology Department, CHU, Brest, France; Faculté de Médecine et des Sciences de la Santé, Université de Bretagne Occidentale, Brest, France; LaTIM, INSERM, UMR 1101, Université de Bretagne Occidentale, Brest, France; CeRePP, Paris, France.
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Current status of prostate brachytherapy in Japan. Jpn J Radiol 2020; 38:934-941. [DOI: 10.1007/s11604-020-00993-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/18/2020] [Indexed: 11/24/2022]
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