Patient-reported Quality of Life After SBRT, LDR, and HDR Brachytherapy for Prostate Cancer

Paly, Jonathan J.; Egleston, Brian L.; Wong, J.K.; Burbure, N.; Sobczak, M.L.; Hayes, S.B.; Chen, David Y.T.; Horwitz, Eric M.; Hallman, M.A.

doi:10.1097/coc.0000000000000796

Cited by 7 publications

(6 citation statements)

References 25 publications

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“…Reassuringly, regardless of baseline urinary function scores, all men who had either LDR-BT or HDR-BT monotherapy in Victoria had excellent urinary function domain score 12month post-treatment, comparable to multiple earlier series on LDR-BT 18,19 or HDR-BT. [20][21][22] The urinary function scores at 12 months after LDR-BT or HDR-BT monotherapy in this study were also comparable to men who had external beam radiation therapy with BT boost in previous PCOR-Vic study 23 (Table 4). On the other hand, it is unknown whether men who had LDR-BT and HDR-BT had comparable baseline sexual function score, 24 given that pre-treatment sexual (dys)function is generally not a selection or exclusion criteria for LDR-BT or HDR-BT.…”

Section: Discussionsupporting

confidence: 63%

Population‐based patient‐reported quality of life outcomes following low‐dose‐rate versus high‐dose‐rate brachytherapy monotherapy for low‐intermediate risk prostate cancer

Ong,

Evans,

Papa

et al. 2023

J Med Imag Rad Onc

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IntroductionTo evaluate patient reported quality of life outcomes (QoL) following low‐dose‐rate brachytherapy (LDR‐BT) and high‐dose‐rate brachytherapy (HDR‐BT) monotherapy for prostate cancer at a population‐based setting.MethodsThe study comprised men with low‐intermediate risk prostate cancer in the Prostate Cancer Outcomes Registry Victoria (PCOR‐Vic), who were treated with LDR‐BT or HDR‐BT monotherapy between 2015 and 2020 and completed the Expanded Prostate Cancer Index Composite (EPIC‐26) questionnaire 12‐month post‐treatment. Men who had ADT were excluded (n = 12). Differences in substantial symptoms (i.e. ‘moderate’ or ‘big’ problem on a 5‐point Likert scale) between LDR‐BT and HDR‐BT arms were evaluated using Pearson's chi‐squared test. Multivariable linear regressions were used to estimate differences in EPIC‐26 urinary, bowel and sexual functional domain scores between LDR‐BT and HDR‐BT arms.ResultsOverall, 198 men were included in this study, of which 167 (84%) had LDR‐BT and 31 (16%) had HDR‐BT. 9 (4.6%), 10 (5.1%) and 56 (28%) reported substantial symptoms for overall urinary, bowel and sexual function at 12‐month post‐treatment, with no significant difference between LDR‐BT and HDR‐BT arms. The adjusted mean differences in urinary incontinence, urinary obstructive, bowel and sexual function domain scores between LDR‐BT and HDT‐BT were: −3.53 (−8.21 to 1.14), −1.27 (−6.88 to 4.35), −0.01 (−5.63 to 5.63) and −8.68 (−21.44 to 4.07) respectively – these were not statistically significant and did not meet the minimal clinically important difference.ConclusionThis is the first Australian population‐based study comparing QoL in men who had LDR‐BT and HDR‐BT, with no statistically or clinically significant differences in QoL observed at 12‐month post‐treatment.

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Section: Discussionsupporting

confidence: 63%

Population‐based patient‐reported quality of life outcomes following low‐dose‐rate versus high‐dose‐rate brachytherapy monotherapy for low‐intermediate risk prostate cancer

Ong,

Evans,

Papa

et al. 2023

J Med Imag Rad Onc

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“…1,2 Low-dose-rate (LDR) prostate brachytherapy (BT-'short distance' therapy in Greek) is one of the most effective methods for the treatment of prostate cancer. 3 Among the available therapeutic modalities, needle insertion (a minimally invasive procedure for biopsy, drug delivery, and ablation) is commonly used because it offers low trauma, fast recovery and high efficacy. 1 LDR-BT involves loading a needle with rice-sized radioactive seeds for insertion into the prostate.…”

Section: Introduction 1| Needle-based Soft Tissue Interventionmentioning

confidence: 99%

“…(3) the pubic arch does not obstruct the needle insertion route. 3 As such, TR prostate BT was used in this study.…”

Section: Introduction 1| Needle-based Soft Tissue Interventionmentioning

confidence: 99%

“…As such, antibiotics are typically administered before surgery and preventive anti‐infection haemostasis treatment is often applied after surgery 6,7 . TR prostate BT offers the following three advantages over TP prostate BT: (1) no anaesthesia is required (TP prostate BT requires general anaesthesia, which increases surgical risks for the elderly); (2) the needle insertion path is shorter, and patients suffer less damage; (3) the pubic arch does not obstruct the needle insertion route 3 . As such, TR prostate BT was used in this study.…”

Section: Introductionmentioning

confidence: 99%

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A needle deflection model with operating condition optimization for corrective force‐based needle guidance during transrectal prostate brachytherapy

Dai

Zhang

Jiang

et al. 2022

Robotics Computer Surgery

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Background Transrectal prostate brachytherapy (BT) involves the permanent implantation of radioactive seeds through a needle, which must be inserted along a straight path to satisfy dose distribution requirements. However, this process is complicated by bevelled needle tips that can cause deflection during penetration. In clinical practice, physicians typically rotate the bevelled tip intermittently or apply manual correction forces near the insertion point, to reduce needle deflection. While assisted rotational insertion robots have made substantial progress in the past 20 years, tissue sticking can be caused by rotation of the bevelled tip and there are currently few studies on the use of corrective forces. As such, an auxiliary needle insertion guide for transrectal prostate BT, based on corrective forces, is investigated in this study for the first time. Methods The proposed BT guide is designed to reduce needle deflection and was experimentally verified by in vitro experiments. An energy‐based deflection model was developed to predict needle motion as corrective forces were applied during insertion. An experimental platform was constructed to perform corrective force‐assisted punctures, using the magnitude of the corrective force (A), the position of corrective force application (B) and the puncture speed (C) as test factors, with needle deflection as a test indicator. Design‐Expert 8.0.5b software was used for simulation, and a high‐definition camera acquired pictures of the needle tip as it pierced the tissue. A regression equation was also established for the test factors and test indicators, using Design‐Expert software. Optimal parameter combinations (A, B and C) were determined through optimization. Results Calculated needle deflection values were then compared with the measured position of the needle insertion point, producing an average error of 0.39 ± 0.28 mm. Deflection was as low as 0.8 mm using optimal puncture parameters Conclusions A needle‐tissue interaction model, considering tissue nonlinearity, which experimental results demonstrated to be highly accurate. Optimal puncture parameters effectively improved puncture accuracy.

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“…Prostate cancer has a low α/β ratio value that favors the use of hypofractionated radiotherapy schedules [3]. Multiple clinical trials have demonstrated that stereotactic body radiation therapy (SBRT) using doses of 7.5-9 Gy per fraction, for a total of five fractions, is safe and likely non-inferior to conventionally fractionated RT regimens [4][5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Automatic localization of the prostatic urethra for image guided radiation therapy

Nasser

Klein

Fenig

et al. 2021

Technical Innovations & Patient Support in Radiation Oncolo

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Treatment of prostate cancer with radiation therapy (RT) requires image guided RT (IGRT) to focus the radiation on the target volumes while minimizing doses to organs at risk. Here we describe a urinary catheter that allows imaging of the prostatic urethra and uses it for automatic localization of the prostate for IGRT. The catheter has a contrast lumen that can be empty or full with contrast. Computerized tomography is performed twice, with contrast lumen empty and full, allowing urethral autosegmentation using digital subtraction. Under ultrasound, continuous urethral visualization is possible by pumping aerated gel in-and out of the contrast lumen.

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Patient-reported Quality of Life After SBRT, LDR, and HDR Brachytherapy for Prostate Cancer

Cited by 7 publications

References 25 publications

Population‐based patient‐reported quality of life outcomes following low‐dose‐rate versus high‐dose‐rate brachytherapy monotherapy for low‐intermediate risk prostate cancer

Population‐based patient‐reported quality of life outcomes following low‐dose‐rate versus high‐dose‐rate brachytherapy monotherapy for low‐intermediate risk prostate cancer

A needle deflection model with operating condition optimization for corrective force‐based needle guidance during transrectal prostate brachytherapy

Automatic localization of the prostatic urethra for image guided radiation therapy

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