Comparison of three different techniques of low-dose-rate seed implantation for prostate cancer

Ishiyama, Hiromichi; Satoh, Takefumi; Sekiguchi, Akane; Tabata, Ken‐ichi; Komori, Shouko; Tsumura, Hideyasu; Kawakami, Shogo; Soda, Itaru; Takenaka, Kouji; Hayakawa, Kazushige

doi:10.5114/jcb.2015.48603

Cited by 6 publications

(10 citation statements)

References 17 publications

(17 reference statements)

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“…A pre-planning technique was used with prostate mapping performed 2-4 weeks prior to seed implantation by TRUS [14]. Ultrasound images were acquired with patients in the extended lithotomy position.…”

Section: Methodsmentioning

confidence: 99%

The impact of body mass index on dosimetric quality in low-dose-rate prostate brachytherapy

Echevarria

Naghavi

Venkat

et al. 2016

jcb

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PurposeLow-dose-rate (LDR) brachytherapy has been established as an effective and safe treatment option for men with low and intermediate risk prostate cancer. In this retrospective analysis, we sought to study the effect of body mass index (BMI) on post-implant dosimetric quality.Material and methodsAfter institutional approval, records of patients with non-metastatic prostate cancer treated in Puerto Rico with LDR brachytherapy during 2008-2013 were reviewed. All patients were implanted with 125I seeds to a prescription dose of 145 Gy. Computed tomography (CT) based dosimetry was performed 1 month after implant. Patients with at least 1 year of prostate-specific antigen (PSA) follow-up were included. Factors predictive of adequate D90 coverage (≥ 140 Gy) were compared via the Pearson χ2 or Wilcoxon rank-sum test as appropriate.ResultsOne-hundred and four patients were included in this study, with 53 (51%) patients having a D90 ≥ 140 Gy. The only factor associated with a dosimetric coverage detriment (D90 < 140 Gy) was BMI ≥ 25 kg/m2 (p = 0.03). Prostate volume (p = 0.26), initial PSA (p = 0.236), age (p = 0.49), hormone use (p = 0.93), percent of cores positive (p = 0.95), risk group (p = 0.24), tumor stage (p = 0.66), and Gleason score (p = 0.61) did not predict D90.ConclusionsIn this study we show that BMI is a significant pre-implant predictor of D90 (< 140 Gy vs. ≥ 140 Gy). Although other studies have reported that prostate volume also affects D90, our study did not find this correlation to be statistically significant, likely because all of our patients had a prostate volume < 50 cc. Our study suggests that in patients with higher BMI values, more rigorous peri-implant dosimetric parameters may need to be applied in order to achieve a target D90 > 140 Gy.

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Section: Methodsmentioning

confidence: 99%

The impact of body mass index on dosimetric quality in low-dose-rate prostate brachytherapy

Echevarria

Naghavi

Venkat

et al. 2016

jcb

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“…The authors acknowledge that the short follow-up and small number of patients are limitations of the study. 26 …”

Section: Electronic Brachytherapymentioning

confidence: 99%

Novel treatment options for nonmelanoma skin cancer: focus on electronic brachytherapy

Kasper¹,

Chaudhary²

2015

MDER

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Nonmelanoma skin cancer (NMSC) is an increasing health care issue in the United States, significantly affecting quality of life and impacting health care costs. Radiotherapy has a long history in the treatment of NMSC. Shortly after the discovery of X-rays and 226Radium, physicians cured patients with NMSC using these new treatments. Both X-ray therapy and brachytherapy have evolved over the years, ultimately delivering higher cure rates and lower toxicity. Electronic brachytherapy for NMSC is based on the technical and clinical data obtained from radionuclide skin surface brachytherapy and the small skin surface applicators developed over the past 25 years. The purpose of this review is to introduce electronic brachytherapy in the context of the history, data, and utilization of traditional radiotherapy and brachytherapy.

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“…Low-dose-rate (LDR) brachytherapy utilizing permanent implant of radioactive seeds is a highly effective treatment option for low and intermediate risk prostate cancer patients [ 1 – 3 ]. In LDR brachytherapy treatment for prostate cancer patients, seed loss and seed displacement are well-recognized [ 4 – 12 ]. Due to inaccuracies in seed placement, blood flow, muscular forces, and edema post-implant, the implanted seeds may experience redistribution and displacement from their intended positions.…”

Section: Purposementioning

confidence: 99%

“…Ishiyama et al . compared pre-plan technique, intraoperative pre-plan technique, and interactive plan technique and found no significant difference in biochemical control among the three groups but the interactive plan showed a significant reduction of the seed migration rate compared to the two other groups [ 12 ].…”

Section: Purposementioning

confidence: 99%

Original paper Evaluation of the dosimetric impact of loss and displacement of seeds in prostate low-dose-rate brachytherapy

Wang¹,

Nasser²,

Borg³

et al. 2015

jcb

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PurposeTo analyze the seed loss and displacement and their dosimetric impact in prostate low-dose-rate (LDR) brachytherapy while utilizing the combination of loose and stranded seeds.Material and methodsTwo hundred and seventeen prostate cancer patients have been treated with LDR brachytherapy. Loose seeds were implanted in the prostate center and stranded seeds in the periphery of the gland. Patients were imaged with transrectal ultrasound before implant and with computerized tomography/magnetic resonance imaging (CT/MR) one month after implant. The seed loss and displacement had been analyzed. Their impact on prostate dosimetry had been examined. The seed distribution beyond the prostate inferior boundary had been studied.ResultsThe mean number of seeds per patient that were lost to lung, pelvis/abdomen, urine, or unknown destinations was 0.21, 0.13, 0.03, and 0.29, respectively. Overall, 40.1% of patients had seed loss. Seed migration to lung and pelvis/abdomen occurred in 15.5% and 10.5% of the patients, respectively. Documented seed loss to urine was found in 3% of the patients while 20% of patients had seed loss to unknown destinations. Prostate length difference between pre-plan and post-implant images was within 6 mm in more than 98% of cases. The difference in number of seeds inferior to prostate between pre-plan and post-implant dosimetry was within 7 seeds for 93% of patients. At time of implant, 98% of seeds, inferior to prostate, were within 5 mm and 100% within 15 mm, and in one month post-implant 83% within 9 mm and 96.3% within 15 mm. Prostate post-implant V100, D90, and rectal wall RV100 for patients without seed loss were 94.6%, 113.9%, and 0.98 cm3, respectively, as compared to 95.0%, 114.8%, and 0.95 cm3 for the group with seed loss.ConclusionsSeed loss and displacement have been observed to be frequent. No correlation between seed loss and displacement and post-plan dosimetry has been reported.

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Comparison of three different techniques of low-dose-rate seed implantation for prostate cancer

Cited by 6 publications

References 17 publications

The impact of body mass index on dosimetric quality in low-dose-rate prostate brachytherapy

The impact of body mass index on dosimetric quality in low-dose-rate prostate brachytherapy

Novel treatment options for nonmelanoma skin cancer: focus on electronic brachytherapy

Original paper Evaluation of the dosimetric impact of loss and displacement of seeds in prostate low-dose-rate brachytherapy

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