Isoray - Innovative Brachytherapy

ASTRO 2018 Insights: building community, innovating and celebrating strong data around the power of Cesium

Building community around the power of Cesium

The radiation oncologist community is one of the cornerstones on which we are building the future of brachytherapy at Isoray. As such, in person engagements at the ASTRO Annual Meeting are some of our most important opportunities to engage both current Cesium Blu clinicians and prospective ones.

This year our interactions at ASTRO 2018 taught us the following:

  1. There is growing awareness of Isoray and the role of Cesium Blu in the treatment of different cancers, including prostate cancer and recurrent, hard to treat tumors.
  2. The radiation oncologists we met with are engaged and excited about the power of Cesium and the potential of our Blu Build loader for intraoperative customized stranding.
  3. Our clinician champions, new products and growing base of outcomes data are powerful resources for us, and for other clinicians interested in growing their own experience with Cesium Blu.

Cesium enjoyed a strong clinical presence across multiple cancer types at ASTRO 2018

In addition to demonstrating sustained control in the longest presented follow-up of prostate cancer patients, other data on Cesium-131 brachytherapy presented demonstrated significant local control for difficult gynecologic, head & neck and brain tumors.

Prostate Cancer Treatment

Dr. Brian Moran

Dr. Brian Moran presented the longest follow-up to date on Cesium for the treatment of prostate cancer.  In his experience, Cesium brachytherapy alone yields 97% biochemical relapse free survival at 5 years and 90% at 10 years for low risk, localized prostate cancer patients.

Moran, Braccioforte. Long Term Results of Cs-131 Monotherapy as Definitive Therapy in a Prospectively-Followed Group of Low Risk Localized Prostate Cancer Patients (Chicago Prostate Cancer Center)

“This analysis represents the longest followed series of Cesium-131 patients reported to-date (10 years) and demonstrates sustained clinical disease control. The closely followed and mature nature of this large prospective group of uniformly low risk patients provides strong evidence for the efficacy of Cesium-131 monotherapy in this setting per biochemical endpoint analysis.”

By the numbers:

○        261 Low risk prostate cancer patients

○        All treated with Cs-131 monotherapy (no EBRT)

○        5 year biochemical relapse free survival (BRFS) 97%

○        10 year BRFS 90%

Brain Cancer Treatment

The team at Johns Hopkins University presented their results in the re-treatment of brain metastases (including Cesium-131 brachytherapy) after failure of radiosurgery. Their results showed that treatment is safe and achieves local control in some patients.

Baker, Kleinberg, et al.  Toxicity and Local Control Outcomes for Brain Metastases Managed with Resection and Aggressive Reirradiation after Initial Radiosurgery Failure (Johns Hopkins University)

For salvage, recurrent brain metastases: with either radiosurgery (n=18) or intracavitary Cesium-131 brachytherapy (n=7), local control at 6 months 79%, local control at 12 months 60%.

Aggressive re-irradiation after resection for pathologic confirmation appears to be appropriately safe for the majority of patients after local failure of initial radiosurgery. Long term local control is achieved for some patients.”

Gynecological Cancer Treatment

The team at the University of Kentucky presented work that showed “Permanent interstitial brachytherapy using Cesium-131 combined with hypo-fractionated external RT is an effective initial treatment strategy for addressing gross disease in patients with vaginal melanoma. It has a favorable toxicity profile, appears to provide excellent local-regional control, and may have the ability to replace surgical resection.”

Larkin, Feddock, et al.  Permanent Interstitial Brachytherapy (PIB) using Cesium-131 in Vaginal Melanoma: A New Wide-Local Radiation Technique (University of Kentucky)

Five women with vaginal melanoma, a very aggressive cancer that usually requires extensive radical surgery, were treated with Cesium-131 implants and EBRT. At a median follow-up time of 19 months, 4 of 5 patients remained locally controlled. No high grade toxicity was observed from the Cs-131 implants.

Future Directions in Head and Neck ReIrradiation

Dr. Min Yao (Case Western Reserve University SoM/ University Hospitals of Cleveland) discussed Cesium-131 as a reirradiation option for recurrent disease in head and neck cancers.

“At the time of last follow-up, 13 out of 14 patients had no disease re-growth within the mesh field.” Conclusion: Cesium provided an option for local control in these difficult to treat cancers.

  • Patients all experience recurrent head & neck cancers
  • Treatment is surgical resection plus cesium-131 mesh brachytherapy
  • At the time of last follow-up 13/14 patients had no disease re-grow within the mesh field, and one re-growth on the edge of the field
  • 1/14 experienced impaired incision healing

Building awareness for the potential of our Blu Build system for intraoperative customized stranding of Cesium-131 seeds

We would like to thank Dr. Brian Moran, Dr. John Sylvester, Dr. Bernard Taylor and others for their participation in, and commentary during, our ASTRO 2018 reception. At this reception we featured the latest outcomes data with Cesium and our Blu Build single-use, disposable system for intraoperative customized stranding of Cesium Blu for prostate cancer brachytherapy. We enjoyed spending time with our customers, and those clinicians interested, discussing Cesium as a part of their treatment arsenal.

Mostly, we are excited about the positive response from clinicians with whom we demonstrated the Blu Build system at ASTRO 2018, affirming the need for this unique device to support intraoperative strand building.

As Blu Build sees action in its first patient cases, we will continue to work closely with our clinician partners to refine its performance in practice and closely watch the associated patient outcomes.

Put the power of Cesium to work for your practice and your patients

With Cesium Blu’s high energy, short half-life and proven efficacy across multiple types of cancer, why wouldn’t you add it to your arsenal of therapeutic modalities? Yes, we’re really asking.

If you’re willing to have this conversation or are interested in learning more, please email

If you’re interested in learning more information about our Blu Build Real Time Loader, please contact Rita Mucavele at

Mike Krachon

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