Permanent prostate brachytherapy preplanned technique: The modern Seattle method step-by-step and dosimetric outcomes

Sylvester, John; Grimm, Peter; Eulau, Stephen M.; Takamiya, Robert; Naidoo, Devi

doi:10.1016/j.brachy.2009.02.001

Cited by 35 publications

(15 citation statements)

References 23 publications

(5 reference statements)

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“…(8–9) Inert biocompatible spacers (brachytherapy), which are frequently implanted for controlling the spatial distribution and accuracy of radiation to the prostate, are critical technical components for radiation delivery but have ‘ zero ’ direct therapeutic benefits. (10–13)…”

Section: Introductionmentioning

confidence: 99%

Nanoparticle-Based Brachytherapy Spacers for Delivery of Localized Combined Chemoradiation Therapy

Kumar

Belz

Markovic

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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Purpose In radiation therapy (RT), brachytherapy inert source spacers are commonly used in clinical practice to achieve high spatial accuracy. These implanted devices are critical technical components of precise radiation delivery but provide no direct therapeutic benefits. Materials and Methods Here we have fabricated Implantable Nanoplatforms or Chemo-Radiation Therapy (INCeRT) spacers loaded with silica nanoparticles (SNPs) conjugated containing a drug, to act as a slow release drug depot for simultaneous localized chemo-radiation therapy. The spacers are made of poly(lactic-coglycolic) acid (PLGA) as matrix, were physically identical (size) to the commercially available brachytherapy spacers (5mm×0.8mm). The silica nanoparticles with diameter 250nm conjugated with near infrared fluorophore Cy7.5 as a model drug and the INCeRT spacers were characterized in terms of size, morphology and composition using different instrumentation techniques. The spacers were further doped with anticancer drug, docetaxel. We have evaluated the in vivo stability, biocompatibility and biodegradation of these spacers in live mouse tissues. Results The electron microscopy studies showed that nanoparticles were distributed throughout the spacers. These INCeRT spacers remained stable and can be tracked using optical fluorescence. In vivo optical imaging studies showed a slow diffusion of nanoparticles from the spacer to the adjacent tissue as opposed to the control Cy7.5-PLGA spacer which showed rapid disintegration in a few days with a burst release of Cy7.5. The docetaxel spacers showed suppression of tumor growth as opposed to control mice over 16 days. Conclusions The imaging with the Cy7.5-spacer and therapeutic efficacy with docetaxel-spacers supports the hypothesis that INCeRT spacers can be used for delivering the drugs in slow, sustained manner in conjunction with brachytherapy, as opposed to rapid clearance of the drugs when administered systemically. The results demonstrate that these spacers with tailored release profiles have potential in improving the combined therapeutic efficacy of chemo-radiation therapy (CRT).

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Section: Introductionmentioning

confidence: 99%

Nanoparticle-Based Brachytherapy Spacers for Delivery of Localized Combined Chemoradiation Therapy

Kumar

Belz

Markovic

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

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“…The Seattle preplan technique was used for all patients (19). Patients were divided into four groups of 50 consecutive patients to assess clinical and global dosimetric differences over time.…”

Section: Methodsmentioning

confidence: 99%

Sector analysis provides additional spatial information on the permanent prostate brachytherapy learning curve

et al. 2015

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“…This method is established and has demonstrated excellent prostate dosimetry results and rectal sparing [11]. …”

Section: Methodsmentioning

confidence: 99%

Re-implantation after insufficient primary 125-i permanent prostate brachytherapy

et al. 2013

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IntroductionWe describe five patients receiving a re-implantation (RI) after post-operative dosimetry of the primary 125-I permanent prostate brachytherapy (BT) for prostate cancer revealed an insufficient dose coverage.Materials and methodsFive out of 222 consecutive patients treated (from March, 2001 to August, 2012) with 125-I BT, received a RI after dosimetric verification by CT and MRI fusion four to eight weeks after implantation displayed an insufficient dose coverage. RIs were performed with 10 to 19 seeds, three to four months after primary intervention. Dosimetry after RI showed an improved and sufficient total dose coverage in all patients.ResultsAt last follow-up (18 to 99 months, median 57 months), none of the patients had relevant implant associated side-effects. Functional outcome was comparable to patients after one-time implantation. PSA levels post intervention showed a decreasing tendency in 4 patients. One patient had a local recurrence after 12 months.ConclusionIn our series, approximately 2% of the patients treated with permanent prostate BT required a RI due to insufficient dose coverage. None of the patients who underwent RI experienced complications. Our series, although only with 5 cases and limited follow-up, along with other published reports, demonstrates good tolerability.

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Permanent prostate brachytherapy preplanned technique: The modern Seattle method step-by-step and dosimetric outcomes

Cited by 35 publications

References 23 publications

Nanoparticle-Based Brachytherapy Spacers for Delivery of Localized Combined Chemoradiation Therapy

Nanoparticle-Based Brachytherapy Spacers for Delivery of Localized Combined Chemoradiation Therapy

Sector analysis provides additional spatial information on the permanent prostate brachytherapy learning curve

Re-implantation after insufficient primary 125-i permanent prostate brachytherapy

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