title: Intraoperative seed placement for thoracic malignancy-A review of technique, indications, and published literature.
abstract: OBJECTIVE
  This review examines the role of permanent radioactive seed implantation in thoracic malignancy. This technique can be used intraoperatively to provide additional highly localized radiation therapy in cases where optimal oncologic margins are unattainable or to palliate unresectable disease.
  
  
  METHODS
  Relevant trials were identified through a systematic literature search using Pubmed.
  
  
  RESULTS
  The intraoperative placement of brachytherapy seeds has been described after sublobar resection for non-small-cell lung cancer (NSCLC), where surgical margins are close or microscopically positive and in the presence of macroscopic residual disease. This brachytherapy technique is currently the focus of a randomized prospective trial in the USA in patients unfit for lobectomy for early-stage NSCLC.
  
  
  CONCLUSIONS
  This review summarizes the methods of brachytherapy seed placement and the published experience of brachytherapy implants within the thorax, also examining radiation safety and postoperative dosimetry. This technique has the potential to improve local control with optimal sparing of normal tissue owing to its highly conformal radiotherapy delivery.
authors.affiliation: Department of Radiotherapy, Royal Surrey County Hospital, Guildford, England, UK. alexandra.stewart@royalsurrey.nhs.uk
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: Stewart
authors.forename: Subhakar
authors.initials: S
authors.lastname: Mutyala
authors.forename: Caroline L
authors.initials: CL
authors.lastname: Holloway
authors.forename: Yolonda L
authors.initials: YL
authors.lastname: Colson
authors.forename: Phillip M
authors.initials: PM
authors.lastname: Devlin
mesh_terms: D001918:Brachytherapy / Q000295:instrumentation / Q000379:methods*; D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy*; D002986:Clinical Trials as Topic; D006801:Humans; D007457:Iodine Radioisotopes; D008479:Mediastinal Neoplasms / Q000532:radiotherapy*; D016019:Survival Analysis
chemical_list: D007457:Iodine Radioisotopes