Study: Cesium brachytherapy for gynecological cancers merits further study

Outpatient brachytherapy using Cesium-131 possible to treat patients battling gynecological cancers along with other medical comorbidities

With a shorter half-life and higher energy than other commonly used radioisotopes, Cesium-131 by Isoray has been shown to be a highly effective cancer treatment when planned appropriately. Cesium-131 Brachytherapy has been widely used to treat prostate cancer and also shows promise in treating head and neck, lung, brain, and gynecological cancers.

In a recent study conducted by Cesium Pioneers Jonathan Feddock, Prakash Aryal, Cole Steber, Jason Edwards, Dennis Cheek, and Marcus Randall using permanent template-guided brachytherapy technique using Cesium-131, five sequential patients with primary or recurrent gynecological malignancies were treated in an outpatient setting. All five suffered from significant medical comorbidities that limited treatment options.

The patients underwent template-guided permanent interstitial brachytherapy (PIB) utilizing Cesium-131 implants. The report is the first to describe a permanent template-guided interstitial technique using Cesium-131 for gynecologic cancers, performed as an low dose radiation (LDR) outpatient procedure- providing promise for patients battling gynecological cancers.

Between all five patients, 40 seeds were implanted. 10 needles carried only Vicryl-stranded sources, and 30 needles carried a combination of stranded Cesium-131 seeds and free seeds. Needle count was between 6 and 10 needles per patient, with active lengths of 4–10 cm. The median dose was 30 Gray (Gy- the absorption of one joule of radiation energy per kilogram of matter) to permanent decay, enabling a cumulative median biological effective dose of 91.5 Gy (range 60.9–92.1 Gy) and equivalent dose at 2 Gy per fraction 75.9 Gy (range 50.7–76.8 Gy).

The results: the calculated median migration distances were less than 1 centimeter in the axial, sagittal, or coronal planes. In 69.2% of cases, the individual seed migration was <5 mm, with no Grade 3 or higher complications occurring.

This study concludes that, compared to current template-guided techniques, use of Cesium-131 implants avoids prolonged bed rest and hospitalization, lowers treatment costs, and enables a higher cumulative dose. Because seed migration is minimal, this technique can be safely performed on an outpatient basis and merits further study.

The original study was published in Brachytherapy an International Multidisciplinary Journal. Read the abstract including purpose, methods, results and conclusion here. The full study report is available to journal subscribers or a one time fee.

Related: Women’s Cancer and Cesium-131 Treatment: 2 presentations from the 2016 Annual Meeting of the American Brachytherapy Society.

“These women were facing very radical surgery to address their recurrent cancers and it turned out that Cesium-131 therapy offered a much better solution for them.” – Dr. Jonathan Feddock, MD, Assistant Professor of Radiation Medicine, University of Kentucky College of Medicine

To learn more about Cesium-131’s capability to improve outcomes for women battling gynecologic cancer, contact


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