High Dose-Rate Afterloading 192Iridium Prostate Brachytherapy: Feasibility Report

Mate, T. P.; Gottesman, James E.; Hatton, J.; Gribble, M.; Hollebeke, Lynn Van

doi:10.1097/00005392-199910000-00109

Cited by 14 publications

(15 citation statements)

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“…Publications on prostate cancer patients treated with conventional fractionated EBRT combined with hypofractionated IMRT boosts 96 of 2 fractions of 5-8 Gy (median follow-up of 63 months) or with concomitant boosts 97,98 in 28 fractions of 2.5 Gy and 25 fractions of 2.7 Gy (median follow-up of 46 and 39 months, respectively) concluded that these treatments were feasible and well tolerated. The results on EBRT treatments in combination with HDRBT boosts 65,66,[99][100][101][102][103][104][105] with median follow-up ranging from 40 to 105 months (2 fractions Â 5-15 Gy, 3 fractions Â 3-6.5 Gy, or 4 fractions Â 3-6 Gy) and extreme hypofractionated treatments of HDRBT delivered as monotherapy [106][107][108][109][110][111][112] at median follow-up of 22-65 months (3 fractions Â 10.5 Gy, 4 fractions Â 8.5-9.5 Gy, 6 fractions Â 6.75-7 Gy, 8 fractions Â 6 Gy, or 9 fractions Â 6 Gy) or stereotactic body radiosurgery [113][114][115] 119,120 median follow-up: 32 months for the hypofractionation regimens and 35 months for the conventional). Despite differences in dose prescription, delivery methods, patient selection according to prognostic factors, short follow-up in many studies, and the use of androgen deprivation therapy in some patients, the clinical experience with hypofractionation seems to be consistent with a low a/b ratio for prostate cancer.…”

Section: Feasibility Of the Hypofractionation Regimensmentioning

confidence: 99%

What do we know about the α/β for prostate cancer?

2012

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Since last decade, the debate on the parameter which reflects prostate cancer sensitivity to fractionation in a radiotherapy treatment, the α/β, has become extensive. Unlike most tumors, the low labeling indices (LI) and large potential doubling time that characterize the prostate tumor led some authors to consider that it may behave as a late responding tissue. So far, the existing studies with regard to this subject point to a low value of α/β, around 2.7 Gy, which may be considered as a therapeutic gain in relation to surrounding normal tissues by using fewer and larger fractions. The aim of this paper is to review several estimates that have been made in the last few years regarding the prostate cancer α/β both from clinical and experimental data, as well as the set of factors that have potentially influenced these evaluations.

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Section: Feasibility Of the Hypofractionation Regimensmentioning

confidence: 99%

What do we know about the α/β for prostate cancer?

2012

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“…We use only one treatment plan, because minimal changes in prostate volume that take place subsequent to the generation of treatment plan, based on plain radiographs, suggest that any dosimetry that is based on it will be adequate for the remainder of the treatment, which was observed in a recent report of Martinez et al [15]. The use of MPD for dose prescription also limits the error involved in target localization and preserves the conformal distribution to the target volume [16].…”

Section: Discussionmentioning

confidence: 99%

Needle Displacement during High-Dose-Rate Afterloading Brachytherapy Boost and Conventional External Beam Radiation Therapy for Initial and Local Advanced Prostate Cancer

Pellizzon

Salvajoli²,

Novaes³

et al. 2003

Urol Int

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Purpose: To determine the displacement of needles (ND) and its impact in the outcome of initial and locally advanced prostate cancer treated with conventional external beam radiation therapy (EBRT) and fractionated transrectal ultrasound-guided high-dose-rate afterloading brachytherapy (HDR-BT) as a boost. Methods and Materials: From 03/97 to 08/98 a total of 47 patients were eligible for study entry. Patients with 1992 AJCC clinical stage T3a or less and prostatic volume ≤60 cm³ were eligible. Prior to HDR-BT, all patients had a course of pelvic localized EBRT up to a median dose of 46 Gy (range 45–50.4). Results: Median age was 68 years (range 47–83) and median follow-up 48 months (range 36–53). Minimal or no needle displacement occurred in 17% (8/47) of patients. There were 61.7% (29/47) of patients who needed one correction and 21.3% (10/47) who needed two corrections. There were no correlations with ND (p = 0.130) and times of ND (p = 0.295) occurrence with bNED. The crude and actuarial biochemical controls (bNED) in 53 months for all patients were 87.2 and 82.3% respectively. Actuarial bNED after 4 years in patients without and with ND were 75 and 89.7% (p = 0.254). Discussion: There are many advantages when HDR-BT is used, but the most important ones are the capability of on-line dosimetry and quality control. The procedure is very conformal, with dose-volume histograms representing the administered dose, but we still need to wait for results of phase III open trials that analyze HDR-BT and conformal therapy.

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“…This is generally thought to be primarily a problem with LDR brachytherapy, in which seed movement can alter the doses received by various areas of the gland. HDR brachytherapy theoretically avoids this problem because the dosimetry is not done until the seeds are already in place [3]. Even so, studies recently have shown how both the interstitial catheter and template tend to shift slightly caudally between HDR fractions [17].…”

Section: Brachytherapymentioning

confidence: 99%

“…This therapeutic modality recently has gained popularity [1] and is facilitated by improved techniques of seed placement involving transrectal ultrasonography. There are two main forms of brachytherapy currently available: 5-mm permanent low-dose rate (LDR) seeds, and high-dose rate (HDR) sources placed temporarily through afterloading catheters [2,3]. LDR typically uses Iodine 125 or Palladium 103, and the dose is transmitted to the prostate over a period of months.…”

Section: Introductionmentioning

confidence: 99%

Management of the complications of external beam radiotherapy and brachytherapy

Loeb

Nadler

2006

Curr Urol Rep

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External beam radiation therapy (EBRT) and brachytherapy are common treatment modalities for newly diagnosed prostate cancer. What complications can patients and physicians expect following these therapies? How are these conditions diagnosed and treated? In this article, we examine several of the most common acute and delayed complications of radiation therapy for prostate cancer. In addition, we discuss appropriate follow-up diagnostics for these patients and our suggestions for management of the main complications that may develop.

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High Dose-Rate Afterloading 192Iridium Prostate Brachytherapy: Feasibility Report

Cited by 14 publications

References 0 publications

What do we know about the α/β for prostate cancer?

What do we know about the α/β for prostate cancer?

Needle Displacement during High-Dose-Rate Afterloading Brachytherapy Boost and Conventional External Beam Radiation Therapy for Initial and Local Advanced Prostate Cancer

Management of the complications of external beam radiotherapy and brachytherapy

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