Needle displacement during HDR brachytherapy in the treatment of prostate cancer

Damore, Steven J; Syed, A.M. Nisar; Puthawala, Ajmel; Sharma, Anil Kumar

doi:10.1016/s0360-3016(99)00477-0

Cited by 104 publications

(57 citation statements)

References 15 publications

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“…The maximum catheter displacement occurred up to approximately 12 hours after the first fraction (20 mm before the second fraction, (9) 7.6 mm before the second fraction, (10) and 6 mm before the third fraction (12) ). Displacement magnitude subsequently decreased for the following fraction.…”

Section: Discussionmentioning

confidence: 97%

“…They reported that needle movement decreased between the subsequent fractions to an average of 4 mm (between the third and fourth fractions). Using measurements of catheter tips by plain films taken before treatment, Damore et al (10) reported a mean displacement of 7.6 mm and a maximum displacement of 28.5 mm between the first and second fractions (40 hours for a total of 4 HDR fractions). They also reported a reduction in needle movement after the first day (to an average of 2 mm between the third and fourth fractions).…”

Section: Discussionmentioning

confidence: 99%

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Measurement of craniocaudal catheter displacement between fractions in computed tomography–based high dose rate brachytherapy of prostate cancer

Kim

Hsu

Pouliot

2007

J Applied Clin Med Phys

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The objective of the present work was to measure the craniocaudal displacement of catheters occurring between consecutive fractions of transrectal ultrasound (TRUS)‐guided high dose rate (HDR) prostate brachytherapy. Ten consecutive patients were treated with 2 fractions of 9.5‐Gy TRUS‐guided HDR brachytherapy, with dental putty being used for the fixation of catheters. For each patient, a computed tomography (CT) scan with 3‐mm slice thickness was acquired before each of the 2 fractions. Two different references were used to measure the catheter displacement between fractions: the ischial bone as a bony marker (BM) and the center of two gold markers (COGM) implanted in the prostate. Catheter displacement was calculated by multiplying the thickness of the CT slice by the difference in number of CT slices between the reference slice and the slice containing the tip of a catheter. The average magnitude of caudal catheter displacement was 2.7 mm (range: −6.0 mm to 13.5 mm) for the BM method and 5.4 mm (range: −3.75 mm to 18.0 mm) for the COGM method. The measurement data obtained from the BM and COGM methods verified that prostate movement and catheter displacement both occurred independently between fractions. The most anterior and medial two catheters (catheter positions 8 and 12) had the greatest tendency to be displaced in the caudal direction because they were located at the most distant position from the fulcrum, making them susceptible to rotation of the dental putty in the lateral plane because of the movement of the patients’ legs between fractions. In conclusion, the combination of the BM and COGM methods can demonstrate prostate and catheter movement relative to the BM between fractions. Our technique found a pattern of catheter displacement. Based on that finding, further improvement of our results may be possible by modification of our current technique.PACS number: 87.53.Jw

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Measurement of craniocaudal catheter displacement between fractions in computed tomography–based high dose rate brachytherapy of prostate cancer

Kim

Hsu

Pouliot

2007

J Applied Clin Med Phys

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“…1 (left) in which there are a number of dominating dwell times in particular positions within the catheter, usually at both ends, leaving the others with very small times or empty. This behavior could potentially lead to localized hot spots and, more importantly, to underdosage of the planning target volume (PTV) and overdosage of the OAR in cases in which there is a displacement of the catheters (15) . Recently the Dwell Time Deviation Constraint (DTDC) parameter has been added to the IPSA optimizer implemented in the Oncentra Brachytherapy (OCB) treatment planning system (TPS) V. 4.3 (Nucletron B.V., Veenendaal, The Netherlands).…”

Section: Introductionmentioning

confidence: 99%

Comparison of IPSA and HIPO inverse planning optimization algorithms for prostate HDR brachytherapy

Panettieri

Smith

Mason

et al. 2014

J Applied Clin Med Phys

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Publications have reported the benefits of using high‐dose‐rate brachytherapy (HDRB) for the treatment of prostate cancer, since it provides similar biochemical control as other treatments while showing lowest long‐term complications to the organs at risk (OAR). With the inclusion of anatomy‐based inverse planning optimizers, HDRB has the advantage of potentially allowing dose escalation. Among the algorithms used, the Inverse Planning Simulated Annealing (IPSA) optimizer is widely employed since it provides adequate dose coverage, minimizing dose to the OAR, but it is known to generate large dwell times in particular positions of the catheter. As an alternative, the Hybrid Inverse treatment Planning Optimization (HIPO) algorithm was recently implemented in Oncentra Brachytherapy V. 4.3. The aim of this work was to compare, with the aid of radiobiological models, plans obtained with IPSA and HIPO to assess their use in our clinical practice. Thirty patients were calculated with IPSA and HIPO to achieve our department's clinical constraints. To evaluate their performance, dosimetric data were collected: Prostate PTV D90(%),V100(%),V150(%), and V200(%), Urethra D10(%), Rectum D2cc(%), and conformity indices. Additionally tumor control probability (TCP) and normal tissue complication probability (NTCP) were calculated with the BioSuite software. The HIPO optimization was performed firstly with Prostate PTV (HIPOPTV) and then with Urethra as priority 1 (HIPOurethra). Initial optimization constraints were then modified to see the effects on dosimetric parameters, TCPs, and NTCPs. HIPO optimizations could reduce TCPs up to 10%–20% for all PTVs lower than 74 cm3. For the urethra, IPSA and HIPOurethra provided similar NTCPs for the majority of volume sizes, whereas HIPOPTV resulted in large NTCP values. These findings were in agreement with dosimetric values. By increasing the PTV maximum dose constraints for HIPOurethra plans, TCPs were found to be in agreement with IPSA without affecting the urethral NTCPs.PACS numbers: 87.55.‐x, 87.55.de, 87.55.dh, 87.53.Jw

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“…The most conformal solutions can be designed in this way, allowing nonuniform dose distribution inside the CTV. When needles are left in tissues, local oedema heightened by the presence of a template can induce caudal displacements [6,14]. Mainly present the first 24 h, the latter were circumvented by loading the catheters on the next day.…”

Section: Discussionmentioning

confidence: 99%

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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Needle displacement during HDR brachytherapy in the treatment of prostate cancer

Cited by 104 publications

References 15 publications

Measurement of craniocaudal catheter displacement between fractions in computed tomography–based high dose rate brachytherapy of prostate cancer

Measurement of craniocaudal catheter displacement between fractions in computed tomography–based high dose rate brachytherapy of prostate cancer

Comparison of IPSA and HIPO inverse planning optimization algorithms for prostate HDR brachytherapy

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

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