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Seed migration to the spinal canal after postresection brachytherapy to treat a large brain metastasis.

TitleSeed migration to the spinal canal after postresection brachytherapy to treat a large brain metastasis.
Publication TypeJournal Article
Year of Publication2016
AuthorsHirschfeld CB, Schwartz TH, Parashar B, A Wernicke G
JournalBrachytherapy
Volume15
Issue5
Pagination637-41
Date Published2016 Sep-Oct
ISSN1873-1449
KeywordsBrachytherapy, Brain Neoplasms, Cesium Radioisotopes, Foreign-Body Migration, Humans, Male, Middle Aged, Prosthesis Failure, Radiotherapy, Adjuvant, Spinal Canal
Abstract

PURPOSE: Seed migration after interstitial prostate brachytherapy has been well documented in the literature. However, there have been no detailed reports of seed migration after permanent interstitial brachytherapy to treat cerebral malignancies. In this article, the authors report a rare case of seed migration after adjuvant cesium-131 ((131)Cs) brachytherapy was used to treat a large paraventricular brain metastasis.

METHODS AND MATERIALS: The patient was a 63-year-old man with a 5.8-cm right frontal metastasis abutting the right lateral ventricle and causing severe edema and mass effect. The patient was enrolled in an ongoing clinical trial at our institution to receive permanent intraoperative (131)Cs brachytherapy in an effort to prevent tumor recurrence in the resection cavity. Stranded seeds were covered with Surgicel, and the cavity was filled with Tisseel to prevent seed migration.

RESULTS: Imaging obtained at 54 days postsurgery showed no seed migration, but imaging obtained at 158 days revealed 12 brachytherapy seeds in the spinal canal from T11 to S2. The seeds were left in place because they were inactive at this time due to the short half-life of (131)Cs (9.7 days); they remained stable on followup imaging, and the patient was asymptomatic.

CONCLUSIONS: Although the clinical consequences remain unclear, the migration of inactive seeds is not currently considered to be a complication of intracerebral brachytherapy and we do not believe that additional measures must be taken to prevent it.

DOI10.1016/j.brachy.2016.06.011
Alternate JournalBrachytherapy
PubMed ID27619561
Grant ListKL2 RR024997 / RR / NCRR NIH HHS / United States
UL1 TR000457 / TR / NCATS NIH HHS / United States
UL1 TR000457 / TR / NCATS NIH HHS / United States