title: Deaths within 12 months after (125)I implantation for brachytherapy of prostate cancer: an investigation of radiation safety issues in Japan (2003-2010).
abstract: OBJECTIVE
  The International Commission on Radiological Protection recommends removing the prostate before cremation if death occurs within 12 months after (125)I brachytherapy. However, the incidence of death within this time frame has not been robustly investigated in any country. The purpose this study was to investigate the incidence and cause of death and actions taken when death has occurred within 12 months after (125)I brachytherapy for prostate cancer in Japan.
  
  
  METHODS
  Data were extracted from the Japan Radioisotope Association database to investigate the total number of implantation cases, number of early deaths after implantation, cause of death, and postmortem actions between September 2003 and the end of June 2010 in Japan. Early death was defined as occurring within 12 months after (125)I brachytherapy for prostate cancer.
  
  
  RESULTS
  During the study period, 15,427 patients underwent (125)I brachytherapy and 43 (0.28%) died within 12 months after implantation. For 37 of the 43 patients (86%), the brachytherapy source was retrieved together with the prostate gland at autopsy; however, autopsy could not be performed in six (14%) of the deceased patients. The largest proportion of early deaths was because of cerebrovascular or cardiovascular disease (17/43, 40%), followed by malignant tumor (15/43, 35%), and respiratory disease or infection (7/43, 16%).
  
  
  CONCLUSIONS
  The incidence of early deaths within 12 months after (125)I brachytherapy in Japan was 0.28%. In almost all cases, the brachytherapy sources were removed in the intact prostate before the body was cremated and stored appropriately.
authors.affiliation: Working Group for Promotion of Permanent Seed Implantation Therapy of Prostate Cancer, Subcommittee of Brachytherapy, Medical Science and Pharmaceutical Committee, Japan Radioisotope Association, Tokyo, Japan. tsatoh@kitasato-u.ac.jp
authors.forename: Takefumi
authors.initials: T
authors.lastname: Satoh
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Yamanaka
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamashita
authors.forename: Manabu
authors.initials: M
authors.lastname: Aoki
authors.forename: Shin
authors.initials: S
authors.lastname: Egawa
authors.forename: Shiro
authors.initials: S
authors.lastname: Saito
authors.forename: Suoh
authors.initials: S
authors.lastname: Sakata
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shibuya
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sugiura
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Nishimura
authors.forename: Tatsuji
authors.initials: T
authors.lastname: Hamada
authors.forename: Tsuneharu
authors.initials: T
authors.lastname: Miki
authors.forename: Atsunori
authors.initials: A
authors.lastname: Yorozu
authors.forename: Takushi
authors.initials: T
authors.lastname: Dokiya
mesh_terms: D001918:Brachytherapy / Q000706:statistics & numerical data*; D002423:Cause of Death; D055700:Cremation / Q000379:methods*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D007564:Japan; D008297:Male; D009027:Mortuary Practice / Q000379:methods; D011471:Prostatic Neoplasms / Q000401:mortality* / Q000532:radiotherapy*; D011834:Radiation Monitoring
chemical_list: D007457:Iodine Radioisotopes