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. 2011 Oct 5;6:130. doi: 10.1186/1748-717X-6-130

Table 2.

Literature Survey of Seed Migration

Patients with seed migration Seed migration rate
Study [ref.] Isotope Loose or linked Number % Number % Location Timing of radiographs
Kumar et al. [11] 125I Linked 0/14 0.0
Steinfeld et al. [17] 125I Loose 1/5 20.0 5/600 0.80 Chest
Grimm et al. [10] 125I/103Pd Loose 39/221 17.6 Chest The day of implant
Nag et al. [14] 103Pd Loose 6/30 20.0 7/3213 0.22 Chest The day of implant or the next follow-up visit (< 1 year)
Nag et al. [15] 103Pd Loose 19/107 17.8 32/10612 0.30 Chest Median of 30 days
Tapen et al. [5] 125I Linked* 1/143 0.7 Chest The day of implant
125I Loose 1/10 10.0 Chest The day of implant
103Pd Loose 15/136 11.0 Chest The day of implant
Overall 17/289 5.9 Chest The day of implant
Merrick et al. [13] 125I Linked/loose† 18/84 21.4 24/13467 0.18 Chest <14 days, or >30 days ††
103Pd loose 16/72 22.2 29/10338 0.28 Chest <14 days, or >30 days §
Overall 34/156 21.8 53/23805 0.22 Chest <14 days, or >30 days ||
Older et al. [16] 103Pd Loose 32/110 29.0 Chest Median of 3 months
Ankem et al. [7] 125I/103Pd Loose 21/58 36.2 34/4755 0.72 Chest Median of 45 days
Eshleman et al. [9] 125I/103Pd Loose 55/100 55.0 119/12135 0.98 Chest 2-3 month
Al-Qaisieh et al. [1] 125I Linked 0/100 0.0 Chest Median of 53 days
Chauveinc et al. [8] 125I Loose 27/170 16.0 32/12179 0.26 Chest 2 months
Kunos et al. [12] 125I/103Pd Loose 43/120 35.8 68/12524 0.54 Chest Median of 133 days
125I/103Pd Loose 41/12524 0.33 Pelvis
Fuller et al. [2] 125I/103Pd Loose 9/37 24.0 11/5688 0.193 Chest 3-12 months
125I/103Pd Loose 2/37 5.4 2/5688 0.035 Pelvis
125I/103Pd Linked¶ 0/23 0.0 0/4018 0.0 Chest
125I/103Pd Linked¶ 0/23 0.0 0/4018 0.0 Pelvis
Stone et al. [18] 125I Loose 4/146 2.7 Chest Median of 30 months
103Pd Loose 0/92 0.0 Chest
Overall 4/238 1.7 10/21654 0.046 Chest
Saibishkumar et al. [4] 125I Loose 4/20 20.0 5/2160 0.23 Chest 1 month
125I Linked 0/20 0.0 0/2236 0.0 Chest
Sugawara et al. [19] 125I Loose 33/11240 0.29 Chest 3 months
125I Loose 3/11240 0.027 Abdomen
125I Loose 10/11240 0.089 Pelvis
Overall 35/158 22.2 46/11240 0.41
Present series 125I Loose 54/267 20 69/19236 0.36 Chest Median of 41 months
125I Loose 6/267 2.2 7/19236 0.036 Abdomen
125I Loose 15/267 5.6 15/19236 0.078 Pelvis
Overall 66/267 25 91/19236 0.47

*Linked seeds were restricted to needles placed at the periphery of the prostate implant. All seeds placed centrally, close to the urethra, were loose seeds. On average, 8-10 loose seeds were used.

†Of the total 125I seeds, 64% were linked seeds. Linked seeds were limited to the region of the capsule/periprostatic region. Loose seeds were utilized in the central aspect of the gland.

††9 patients, within 14 days; 75 patients, more than 30 days.

§11patients within 14 days; 61patients, more than 30 days.

||Of the 20 patients who had postimplant chest radiographs obtained within 14 days of brachytherapy, none had seeds detected in the lungs. Categorizing patients by isotope, for 125I, 18/75 (24.0%) and for 103Pd, 16/61 (26.2%) with chest radiographs beyond 30 days had seeds found in the lungs.

¶A mixture of linked and free seeds, with a median 74% of needles per case containing seeds in linked, with central and posterior needles typically containing loose seeds.