Radioactive seed migration to the chest after transperineal interstitial prostate brachytherapy: Extraprostatic seed placement correlates with migration: Eshleman JS, Davis BJ, Pisansky TM, Wilson TM, Haddock MG, King BF, Darby CH, Lajoie WN, Oberg AL, Di

Purpose mine the incidence of seed migration detected on chest X-ray and to identify the predictors associated with its occurrence. s and materials n May 1998 and April 2000, 102 patients underwent permanent prostate brachytherapy at our institution and 100 were eligible for the study. Chest X-rays obtained at follow-up were examined for the number and location of seeds. The patient and treatment variables potentially associated with the occurrence and number of seed migrations were analyzed. s more seeds were identified on the chest X-rays of 55 (55%) of 100 patients. The mean number of intrathoracic seeds in patients with migration was 2.2 (range, 1–10), and the proportion of seeds that migrated to the thorax was 0.98%. The rate of extraprostatic seeds planned was 43.9%, and postimplant CT identified 37.9% in such a location. The number of seeds planned for extraprostatic placement and below the apex were statistically significant (alpha = 0.05) predictors in univariate logistic analysis. Multivariate analysis revealed the planned number of extraprostatic seeds as the only statistically significant predictor (p = 0.04). sion rostatic placement of loose seeds is associated with an increased likelihood for, and frequency of, seed migration to the thorax. Nonetheless, the small proportion of implanted seeds that migrated (⩽1%) is highly unlikely to have significant dosimetric consequences.