Low dose rate prostate brachytherapy

Stish, Bradley J.; Davis, Brian J.; Mynderse, Lance A.; McLaren, Robert H.; Deufel, Christopher L.; Choo, Richard

doi:10.21037/tau.2017.12.15

Cited by 34 publications

(28 citation statements)

References 126 publications

(120 reference statements)

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“…The International Commission on Radiologic Units and Measurements defines HDR as a dose delivered at a rate >12 Gy/h, although in actuality this is usually much higher, often in excess of 1 Gy per minute (7,12). With regards to radiation biology, the degree of dose escalation achievable with HDR brachytherapy, compared to other EBRT techniques and LDR, may be more effective in killing prostate cancer cells (7,20,21). The rapid dose delivery seen in HDR is considered to be selectively more damaging to cells with lower alpha/beta ratios, such as prostate cancer and late responding normal tissues (22)(23)(24).…”

Section: Hdr Boostmentioning

confidence: 99%

A Brief Review of Low-Dose Rate (LDR) and High-Dose Rate (HDR) Brachytherapy Boost for High-Risk Prostate

et al. 2019

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For patients with unfavorable or high-risk prostate cancer, dose escalated radiation therapy leads to improved progression free survival but attempts to deliver increased dose by external beam radiation therapy (EBRT) alone can be limited by late toxicities to nearby genitourinary and gastrointestinal organs at risk. Brachytherapy is a method to deliver dose escalation in conjunction with EBRT with a potentially improved late toxicity profile and improved prostate cancer related outcomes. At least three randomized controlled trials have demonstrated improved biochemical control with the addition of either low-dose rate (LDR) or high-dose rate (HDR) brachytherapy to EBRT, although only ASCENDE-RT compared brachytherapy to dose-escalated EBRT but did report an over 50% improvement in biochemical failure with a LDR boost. Multiple single institution and comparative research series also support the use of a brachytherapy boost in the DE-EBRT era and demonstrate excellent prostate cancer specific outcomes. Despite improved oncologic outcomes with a brachytherapy boost in the high-risk setting, the utilization of both LDR, and HDR brachytherapy use is declining. The acute genitourinary toxicities when brachytherapy boost is combined with EBRT, particularly a LDR boost, are of concern in comparison to EBRT alone. HDR brachytherapy boost has many physical properties inherent to its rapid delivery of a large dose which may reduce acute toxicities and also appeal to the radiobiology of prostate cancer. We herein review the evidence for use of either LDR or HDR brachytherapy boost for high-risk prostate cancer and summarize comparisons between the two treatment modalities.

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Section: Hdr Boostmentioning

confidence: 99%

A Brief Review of Low-Dose Rate (LDR) and High-Dose Rate (HDR) Brachytherapy Boost for High-Risk Prostate

et al. 2019

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“…Different brachytherapy sources with own design have been studied utilizing Monte Carlo (MC) simulation and experimentally by different dosimeters [1][2][3][4][5][6][7]. Among the sources, 125 I seed also has designed and used to cancerous tissue treatment [8][9][10][11][12]. Villagas et al [9] conducted a study to characterize the magnitude of the spread in specific energy deposition per cell and reported increasing in micro-dosimetric value with decreasing target size and decreasing energy of the radiation quality.…”

Section: Introductionmentioning

confidence: 99%

“…Among the sources, 125 I seed also has designed and used to cancerous tissue treatment [8][9][10][11][12]. Villagas et al [9] conducted a study to characterize the magnitude of the spread in specific energy deposition per cell and reported increasing in micro-dosimetric value with decreasing target size and decreasing energy of the radiation quality. They also reported that in clinical relevant dose the maximum spread dose 6% for 125 I.…”

Section: Introductionmentioning

confidence: 99%

“…On the other study, Teles et al [13] characterized two 125 I and 103 Pd brachytherapy seeds at different depths in the water. Bradley et al [9] in a study on the prostate low dose rate (LDR) radiotherapy reported it with excellent outcome and reported it superior radiation dose escalation and conformity compared to external beam radiation therapy (EBRT). Davis et al [14] chose 125 I LDR brachytherapy because of their reported reason; the notable difference between the sources is the longer half-life (t 1/2 ), or rate of radioactive decay for 125 I (t 1/2 =59.4 days) relative to 103 Pd (t 1/2 =17 days) or 131 Cs (t 1/2 =9.7 days).…”

Section: Introductionmentioning

confidence: 99%

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Monte Carlo study on the gold and gadolinium nanoparticles radio-sensitizer effect in the prostate ¹²⁵I seeds radiotherapy

Ghasemi-Jangjoo

Ghiasi

2019

Polish Journal of Medical Physics and Engineering

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Monte Carlo and TL dosimetry applied to the characterization of 125I brachytherapy with a different design with other 125I seeds. In a water phantom, lattice configuration simulated with 125I seed in the center and 10 nm gold and gadolinium nan-particle filed voxels. This simulation conducted to the characterization of the nano-particles DEF in low energy and prostate tissue. To study of the prostate brachytherapy, a humanoid computational phantom developed by CT slices applied. KTMAN-2 computational phantom contains 29 organs and 19 skeletal regions and was produced from cross-sectional x-ray computed tomography (CT slices) images. The simulated seed was 125I seed having an average energy of 28.4 keV for photons, a half-life of 59.4 days. DEF factor in the seed radiation energy (28.4 keV) DEF factor was found to be two times higher for the gold nano-particles. It was revealed than gold-nano-particles posing Z about 1.24 times higher than gadolinium led to around 200% DEF increasing in the same conditions and the nano-particles size. It was concluded that in low energy sources brachytherapy, photoelectric is dominant in the presence of relative high element nanoparticles. This leads to a high dose increasing in some micro-meters and causes a dramatic dose gradient in the vicinity of a nano-particle. This dose gradient effectively kills the tumor cells in continuous low energy irradiation in the presence of a high Z material nano-scaled particle. Application of gold nano-particles in low energy brachytherapy is recommended.

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“…For brachytherapy, radioisotopes with energy <50 keV, such as 125 I and 103 Pd sources [7-9] with typical implants of 50-80 metallic seeds encasing isotopes, are used as low dose rate (LDR) [10] therapies for the treatment of prostate cancer, uveal melanomas and brain tumours. The dose is estimated by a number of computer codes such as EGSnrc, GEANT [11], PENELOPE [12] and MCNP [13] based on Monte Carlo (MC) methods [14].…”

Section: Introductionmentioning

confidence: 99%

Radiation dose delivered by 125I, 103Pd and 131Cs and dose enhancement by gold nanoparticle (GNP) solution in prostate brachytherapy: a comparative analysis by Monte Carlo simulation

Khan

Aziz²,

Koreshi³

2019

IIUMEJ

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: The energy deposition and radiation dose from commonly used radioisotopes, 125I,103Pd, and 131Cs, used for brachytherapy of cancers is estimated using Monte Carlo (MC) simulations. To enhance the dose, gold nanoparticle (GNP) solutions are injected into the tumor; this results in more effective and shorter therapy duration. It is thus important to estimate the dose enhancement factor (DEF) achievable by a radioisotope. The research presented in this paper thus focuses on a comparative analysis of radioisotopes. To estimate the radiation dose, the Monte Carlo N-particle code MCNP5 was used for a coupled photon-electron simulation of radiation transport from radiation emanating from seeds of radioisotopes implanted in the prostate at positions prescribed to deliver effective doses to the tumor while protecting neighbouring vital organs such as the rectum and urethra. The quantities tallied were the energy deposition (F6 tally) and the pulse heights (*F8 tally) in specified energy bins. The energy deposited in the tumor was used to estimate the absorbed dose to the prostate incorporating the transformations of the radioisotopes during decay. The absorbed dose was subsequently estimated for a GNP-tissue solution with a concentration of 25 mg Au/g of prostate tissue, modelled as a homogenous mixture. From the simulations, it was found that the lifetime absorbed dose is ~96 Gy from 98 seeds, each of 0.31 mCi, of 125I; ~102 Gy, from 115 seeds, each of 1.4 mCi, of 103Pd, and ~90 Gy from 131Cs seeds replacing 103Pd seeds of the same initial activity. The main advantage of 131Cs, over 125I and 103Pd, is observed in the larger dose rate (~26 cGy/hr) delivered initially i.e. in the first few days which is 1.5 and 5.7 times higher than that for 103Pd and 125I. The absorbed dose for 125I, 103Pd and 131Cs increases to ~245, ~130, ~187 Gy respectively with GNP-tissue solution of 25 mg Au/g tissue. From the analysis, it is found that while the lifetime absorbed dose of all three radioisotopes is of the same order, there are advantages in using 131Cs; these advantages are further quantified. ABSTRAK: Pemendapan tenaga dan dos sinaran radiasi daripada radioisotop yang biasa digunakan, 125I,103Pd, dan 131Cs, digunakan bagi terapibraki kanser dianggar menggunakan simulasi Monte Carlo (MC). Bagi meningkatkan dos, larutan partikel nano emas (GNP) telah disuntik ke dalam tumor; ini lebih memberi kesan dan mengurangkan masa terapi. Oleh itu, adalah penting menganggar faktor dos penggalak (DEF) dapat dicapai dengan radioisotop. Kajian ini mengfokuskan pada analisis perbandingan radioisotop. Bagi menganggarkan dos radiasi, kod Monte Carlo N-partikel MCNP5 telah digunakan pada simulasi pasangan foton-elektron pengangkutan radiasi daripada pancaran radioaktif benih radioisotop yang ditanam dalam prostat pada posisi yang disebut bagi mencetuskan dos penghantaran yang berkesan pada sel tumor. Dalam masa sama melindungi organ penting seperti rektum dan uretra. Kuantiti diselaras dengan pemendapan tenaga (selaras F6) dan ketinggian denyut (selaras *F8) dalam aras tenaga sebenar. Tenaga yang dienap dalam sel tumor ini telah digunakan bagi menganggarkan dos serapan pada prostat dengan menggabungkan transformasi radioisotop ketika susutan. Dos yang diserap telah kemudiannya dianggarkan bagi larutan tisu-GNP dengan ketumpatan 25 mg Au/g tisu prostat, dimodelkan sebagai campuran homogen. Daripada simulasi, dapatan kajian menunjukkan dos diserap sebanyak ~96 Gy daripada 98 benih, setiap satu daripada 0.31 mCi, 125I; ~102 Gy, dari 115 benih, setiap 1.4 mCi, dari 103Pd, dan ~90 Gy daripada benih 131Cs menggantikan benih 103Pd pada pemulaan aktiviti yang sama. Keistimewaan utama adalah 131Cs, ke atas 125I dan 103Pd, telah dilihat dalam kadar dos lebih besar (~26 cGy/hr) dikeluarkan pada pemulaannya iaitu dalam beberapa hari pertama iaitu 1.5 dan 5.7 kali lebih tinggi daripada 103Pd dan 125I. Dos yang diserap pada 125I, 103Pd dan 131Cs bertambah kepada ~245, ~130, ~187 Gy masing-masing dengan larutan tisu-GNP sebanyak 25 mg Au/g tisu. Hasil analisis menunjukkan penyerapan seumur hidup dos diserap pada ketiga-ketiga radioisotop dalam aturan yang sama, ini adalah keistimewaan menggunakan 131Cs; keistimewaan ini akan terus diuji pada masa depan dan diukur kuantitinya.

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Low dose rate prostate brachytherapy

Cited by 34 publications

References 126 publications

A Brief Review of Low-Dose Rate (LDR) and High-Dose Rate (HDR) Brachytherapy Boost for High-Risk Prostate

A Brief Review of Low-Dose Rate (LDR) and High-Dose Rate (HDR) Brachytherapy Boost for High-Risk Prostate

Monte Carlo study on the gold and gadolinium nanoparticles radio-sensitizer effect in the prostate ¹²⁵I seeds radiotherapy

Radiation dose delivered by 125I, 103Pd and 131Cs and dose enhancement by gold nanoparticle (GNP) solution in prostate brachytherapy: a comparative analysis by Monte Carlo simulation

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Low dose rate prostate brachytherapy

Cited by 34 publications

References 126 publications

A Brief Review of Low-Dose Rate (LDR) and High-Dose Rate (HDR) Brachytherapy Boost for High-Risk Prostate

A Brief Review of Low-Dose Rate (LDR) and High-Dose Rate (HDR) Brachytherapy Boost for High-Risk Prostate

Monte Carlo study on the gold and gadolinium nanoparticles radio-sensitizer effect in the prostate 125I seeds radiotherapy

Radiation dose delivered by 125I, 103Pd and 131Cs and dose enhancement by gold nanoparticle (GNP) solution in prostate brachytherapy: a comparative analysis by Monte Carlo simulation

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Monte Carlo study on the gold and gadolinium nanoparticles radio-sensitizer effect in the prostate ¹²⁵I seeds radiotherapy