Side Effects of Permanent Radioactive Iodine-125 Implants Brachytherapy for Prostate Cancer in Nigeria.

BACKGROUND

Radioactive seeds implant is a novel option in the developed world for the treatment of organ-confined prostate cancer; however, it is a rare procedure in developing countries, especially in sub-Saharan African countries like Nigeria. The first prostate brachytherapy in Nigeria was performed in 2019 at La'Newton Oncology Clinic using low-dose radioactive iodine-125. The side effects on patients that were treated in three years of its existence in Nigeria are documented in this study.

OBJECTIVES

This study aimed to narrate the side effects and complications of the procedure in its three years of existence in Nigeria.

METHODS

This was a retrospective study of the 32 eligible patients treated at the only private clinic that offers permanent radioactive iodine-125 prostate seeds implant in Nigeria. The patients were followed-up for 24 months. The biodata, urinary symptoms and erectile function were analyzed using the medical records, a detailed expanded prostate cancer index composite questionnaire, and a modified Radiation Therapy Oncology Group Grading System.

RESULT: It was noticed that the burning sensation at the perineum, which was self-limiting within 72 hours, was a major complaint among all the subjects. All the patients experienced haematuria; 74% of the subjects noted that the haematuria resolved within 12 hours post-implant, while it resolved within 24 hours for the remaining 26%. Acute urinary retention occurred in one subject. The EPIC scoring system showed that only one subject lost the ability to have a firm erection adequate for sexual intercourse. There was no gastrointestinal toxicity recorded among the participants.

CONCLUSION

The side effects observed among the subjects were negligible compared to conventional surgery, so this procedure should be considered in all cases of organ-confined prostate cancer, especially as it is also cost-effective.