Late normal tissue injury from permanent interstitial implants.
OBJECTIVE
To develop a simple method of calculating biologically effective doses in high-dose regions of permanent interstitial implants.


METHODS
The incomplete repair model is used to clarify the relationship between dose, D, and biologically effective dose (BED), for permanent interstitial implants. The relationship is used to ascertain the BED at high-dose regions that may occur in (125)I, (103)Pd, and (198)Au prostate implants.


RESULTS
The relationship between D and BED is nonlinear and is given by BED(D) = D + D(2)/D(lambda), where D(lambda) = [(t(lambda)/t(mu)) + 1](alpha/beta), t(lambda) and t(mu) are the half-lives of the isotope and of sublethal damage repair respectively, and alpha/beta is the alpha:beta ratio. Idealized geometrically identical (125)I, (103)Pd, and (198)Au prostate implants with minimum target dose (MTD) of 160 Gy, 120 Gy, and 64 Gy, respectively, are considered. The BED for (103)Pd and (198)Au will be less than the BED for (125)I, for doses up to about 2.5 times the MTD. For higher doses, the BED for (103)Pd may be significantly higher than for (125)I.


CONCLUSIONS
Permanent interstitial implants using short-lived isotopes may have regions with very high biologically effective doses.
Division of Medical Imaging and Radiopharmaceutical Drug Products, Center For Drug Evaluation and Research, U.S. Food and Drug Administration, Rockville, MD, USA. yaesr@cder.fda.gov
R J
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Yaes
D000465:Algorithms; D001918:Brachytherapy / Q000009:adverse effects* / Q000379:methods; D006050:Gold Radioisotopes / Q000009:adverse effects*; D006207:Half-Life; D006801:Humans; D007457:Iodine Radioisotopes / Q000009:adverse effects*; D016014:Linear Models; D010165:Palladium / Q000009:adverse effects*; D011868:Radioisotopes / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D012062:Relative Biological Effectiveness
D006050:Gold Radioisotopes; D007457:Iodine Radioisotopes; D011868:Radioisotopes; D010165:Palladium