January 7, 2006. A new radiation therapy for prostate cancer -- Cesium-131 brachytherapy -- has fewer side effects than other treatments. NewYork-Presbyterian Hospital/Weill Cornell Medical Center is the only hospital in the Northeast to offer the new therapy.
Brachytherapy involves the implantation of radioactive seeds into the tumor site. Radiation kills or arrests the growth of the cancer with minimal damage to healthy tissue. This helps prevent incontinence and preserve the nerves that allow for erection.
The radioactive isotope Cesium-131, which was approved in 2003 by the FDA for use in brachytherapy for prostate cancer and other malignancies, has several advantages over other isotopes. Compared to Iodine-125 and Palladium-103, it has a higher energy, shorter half-life, and uses a lower total dose of radiation.
Cesium-131 has a half-life of about 10 days, compared to a half-life of 17 days and 60 days for Palladium-103 and Iodine-125, respectively. A shorter half-life means faster dose delivery, that cancer cells have less opportunity to repopulate, and less protracted radiation to normal healthy tissues. The energy emitted by Cesium-131 is stronger than Iodine-125 and Palladium-103 (29 KeV vs. 28 KeV and 21 KeV, respectively). Because the energy is stronger, fewer radioactive seeds are required. This reduces risk of urinary reactions following implantation.
"Cesium-131 brachytherapy is nothing less than a new standard of care for treatment of prostate cancer, giving patients an improved quality of life and peace of mind," says Dr. Dattatreyudu Nori, professor of clinical radiology at Weill Medical College of Cornell University and radiation oncologist-in-chief at NewYork-Presbyterian/Weill Cornell.
A pioneer in the field of brachytherapy, Dr. Nori was among those who helped introduce Iodine-125 in 1970 and Palladium-103 in 1985. "The introduction of a new isotope has happened every 15 to 20 years," he says.
Cesium-131 brachytherapy is available to low-risk/early-stage prostate cancer patients. In the near future it may also be available to intermediate-risk patients, eliminating the need for supplemental external beam radiation in this population.
Cesium-131 brachytherapy treatment is manufactured by IsoRay Medical of Richland, Wash.
Medical Center Implants First-ever Cesium-131 Brachytherapy Seeds To Treat Prostate Cancer October 2004
Dr Nori's home page at Weill-Cornell, NY, NY
Nori's page at New York Hospital, Queens
Cesium-131 dreams become reality (Pacific Northwest National Laboratory)
Cesium-131 (Isoray)
IsoRay Medical's Cesium-131 Brachytherapy Treatment Combined with External Beam Radiation Therapy for the First Time at the Arnold Palmer Prostate Center at Eisenhower Medical Center November 22, 2005 (press release, source: Isoray)
Recent publication by Dr. Nori about standard brachytherapy plus external beam radiation:
Technol Cancer Res Treat. 2004 Aug;3(4):335-45. The impact of technological advances on the evolution of 3D conformal brachytherapy for early prostate cancer. Nori D, Reddy NM, Vaughan ED Jr, Shemtov MM.Department of Radiation Oncology, New York Hospital Queens, 56-45 Main Street, Flushing, NY 11355, USA.
Permanent implantation of I-125 and Pd-103 seeds is one of the widely used treatment options for the early stage prostate cancer with minimum normal tissue complications and long-term local control of the tumor. This is possible because of several technological advances made in the past decade to better understand the procedural aspects of implantations with the desired clinical outcome and with acceptable morbidities.
In addition, with the widespread use of PSA testing, more widely disseminated information about prostate cancer and increased patient awareness, over 70% of patients are diagnosed early with localized disease and therefore are candidates for definitive local therapy.
Delineation of soft tissue structures including the prostate, rectum, urethra and bladder has become more accurate with the use of imaging modalities including Ultrasound and MRI, with or without the CT.
A re-evaluation of the dosimetric parameters of the radioactive sources has lead to a more precise estimate of the dose delivered to the prostate and the associated critical normal structures.
Technological improvements in the post implant dosimetry have helped to understand the factors, which makes an implant a "good implant" or a "poor implant".
Intraoperative treatment planning with on line dosimetry is emerging as one of the best approaches for prostate brachytherapy. In addition, better software is now available producing dose-volume histograms with 3D target and normal tissue reconstruction.
The combination of seed implant followed by IMRT would provide scope for differentially boosting the regions under-dosed because of uncontrollable and unexpected reasons during the implant and unsuspected micro extensions of the tumor.
advertising
We subscribe to the HONcode principles.
Verify here.
I Can Cope program for cancer patients and their families