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

West African Journal of Medicine 2023 December; 40(12): 1369-1377 PMID: 38266199

Abstract

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.