Dose escalation using conformal high-dose-rate brachytherapy improves outcome in unfavorable prostate cancer

Martínez, Álvaro; Gustafson, Gary; González, José; Armour, Elwood P.; Mitchell, C.; Edmundson, Gregory K.; Spencer, W. F.; Stromberg, Jannifer S.; Huang, Ran; Vicini, Frank A.

doi:10.1016/s0360-3016(02)02733-5

Cited by 204 publications

(97 citation statements)

References 36 publications

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“…For intermediate and high‐risk patients (PSA > 10 and/or Gleason score > 6 and/or stage > T2c), HDR brachytherapy is more commonly used, mainly as a boost strategy, producing excellent PSA control and negative biopsy results in patients with intermediate‐ and high‐risk prostate cancer 26, 27, 28. However, TIPPB alone is a treatment option for some low‐tier intermediate risk prostate cancer patients and can also be used as a boost modality 23, 24, 25…”

Section: System Descriptionmentioning

confidence: 99%

COMP report: CPQR technical quality control guidelines for low‐dose‐rate permanent seed brachytherapy

Beaulieu¹,

Radford

Villarreal-Barajas

2018

J Applied Clin Med Phys

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The Canadian Organization of Medical Physicists (COMP), in close partnership with the Canadian Partnership for Quality Radiotherapy (CPQR) has developed a series of Technical Quality Control (TQC) guidelines for radiation treatment equipment. These guidelines outline the performance objectives that equipment should meet in order to ensure an acceptable level of radiation treatment quality. The TQC guidelines have been rigorously reviewed and field tested in a variety of Canadian radiation treatment facilities. The development process enables rapid review and update to keep the guidelines current with changes in technology. This article contains detailed performance objectives and safety criteria for low‐dose‐rate (LDR) permanent seed brachytherapy.

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Section: System Descriptionmentioning

confidence: 99%

COMP report: CPQR technical quality control guidelines for low‐dose‐rate permanent seed brachytherapy

Beaulieu¹,

Radford

Villarreal-Barajas

2018

J Applied Clin Med Phys

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“…Overall survival reflected all deaths while cause-specific survival was based on events attributed to prostate cancer alone. The late side effects were recorded according to the Radiation Therapy Oncology Group (RTOG) glossary expanded to brachytherapy [22]. The actuarial rates were calculated using the Kaplan-Meier method [16].…”

Section: Data Collection and Statistical Analysesmentioning

confidence: 99%

“…A P-value of %0.05 was considered statistically significant. The intervals were calculated from the date of Bt completion as published for HDR Bt procedures [22].…”

Section: Data Collection and Statistical Analysesmentioning

confidence: 99%

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192Ir low dose rate brachytherapy for boosting locally advanced prostate cancers after external beam radiotherapy: A phase II trial

Nickers¹,

Coppens

Leval

et al. 2006

Radiotherapy and Oncology

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Background and purpose: To evaluate on 201 locally advanced prostatic cancers prospectively treated in a phase II trial, the efficacy of a combination of external beam radiotherapy (39.6 Gy) and 192 Ir low dose rate brachytherapy (Bt) (40-45 Gy).Patients and methods: Sixty-four patients were included in the intermediate prognosis group with only one of the following adverse factors (PSAO10 ng/ml, Gleason scoreR7 or clinical stageRT2b) and 137 in the unfavourable group when at least two of these factors were present.Results: The actuarial 4 years biochemical no evidence of disease is 82.8% for the entire population. It is, respectively, 97 and 76% in the intermediate and unfavourable prognosis groups (P!0.0001). GradeR3 late urinary complications occurred in 13 patients (6.5%). Eight patients (4%) presented late grade 2 rectal complications but no grades 3-5 was observed.Conclusions: Even if an a/b of 1.5-3 Gy theoretically favours the use of a high dose rate mode of irradiation, the early results presented here are as good as those reported for similar groups of patients with high dose rate treatments. Late toxicity is identical but our urinary toxicity is within the less favourable and rectal toxicity within the most favourable results.We can postulate that while inducing very high hyperdosage regions (V150) mainly focused on the peripheral zone, most of the Bt techniques consist of a more ablative treatment. Many of the radiobiological studies on Bt did not in fact take into account the heterogeneity of irradiation inside the CTV. This study highlights the need to explore pulsed dose rate therapies, permanent implant and new available radioisotopes such as 169 Ytterbium that will offer the safety of low and lower dose rates. The actual late toxicity of the different Bt techniques is not yet inexistent indeed. q

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“…With the aim to optimize the therapeutic ratio, in lieu of external beam X-ray irradiation, various treatment modalities have been advocated, including particle therapy and brachytherapy, both in the form of permanent seed implants 17 or high dose rate 18 temporary implants, either alone or in conjunction with external beam irradiation.…”

Section: Introductionmentioning

confidence: 99%

Particle therapy in prostate cancer: a review

Greco

2007

Prostate Cancer Prostatic Dis

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While dose escalation is proving important to achieve satisfactory long-term outcomes in prostate cancer, the optimal radiation modality to deliver the treatment is still a topic of debate. Charged particle beams can offer improved dose distributions to the target volume as compared to conventional 3D-conformal radiotherapy, with better sparing of surrounding healthy tissues. Exquisite dose distributions, with the fulfillment of dose-volume constraints to normal tissues, however, can also be achieved with photon-based intensity-modulated techniques. This review summarizes the literature on the use of particle therapy in prostate cancer and attempts to put in perspective its relative merits compared to current photon-based radiotherapy.

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Dose escalation using conformal high-dose-rate brachytherapy improves outcome in unfavorable prostate cancer

Cited by 204 publications

References 36 publications

COMP report: CPQR technical quality control guidelines for low‐dose‐rate permanent seed brachytherapy

COMP report: CPQR technical quality control guidelines for low‐dose‐rate permanent seed brachytherapy

192Ir low dose rate brachytherapy for boosting locally advanced prostate cancers after external beam radiotherapy: A phase II trial

Particle therapy in prostate cancer: a review

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